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BUSINESS AUTO COVERAGE PART DECLARATIONS <br />PRODUCER:POLICY NUMBER: 2020-35634Personal Care & Assisted Living Insurance Center <br />P.O. Box 933 <br />Hanover, PA 17331 <br />NAME OF INSURED AND MAILING ADDRESS: <br />RENEWAL OF NUMBER: 2019-35634 <br />Item One:Voices Together <br />88 Vilcom Center Dr. Suite 100 <br />Chapel Hill, NC 27514 <br />POLICY PERIOD: FROM TO 10/10/2021 <br />AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE <br />BUSINESS DESCRIPTION: <br />IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS <br />POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE AS STATED IN THIS POLICY. <br />Item Two: SCHEDULE OF COVERAGES AND COVERED AUTOS. <br />This policy provides only those coverages where a charge is shown in the premium column below. Each of these coverages will apply only to those "autos" <br />shown as covered "autos". "Autos" are shown as covered "autos" for a particular coverage by the entry of one or more of the symbols from the COVERED <br />AUTOS Section of the Business Auto Coverage Form next to the name of the coverage. <br />10/10/2020 <br />Therapeutic music program for people with developmental disabilities <br />COVERED AUTOS <br />N/AN/A SEPARATELY STATED IN EACH P.I.P. <br />ENDORSEMENT. <br />PERSONAL INJURY <br />PROTECTION (or equivalent <br />No-fault Coverage) <br />N/AEXCLUDEDN/ALIABILITY CSL <br />PREMIUMTHE MOST WE WILL PAY FOR ANY <br />ONE ACCIDENT OR LOSS <br />Entry of one or more of the symbols from <br />the COVERED AUTOS Section of the <br />Business Auto Coverage Form shows <br />which autos are covered autos. <br />COVERAGES <br />N/A <br />$200 <br />$50 <br />EXCLUDED <br />INCLUDED <br />$1,000,000 CSL <br />N/A <br />9 <br />8 <br />AUTO MEDICAL PAYMENTS <br />NONOWNED AUTO <br />HIRED AUTO <br />ADDED PERSONAL INJURY <br />PROTECTION (or equivalent <br />added No-fault Coverage) <br />N/A <br />SEPARATELY STATED IN EACH P.I.P. <br />ENDORSEMENT.N/A <br />LIMIT <br />UNINSURED MOTORIST N/A EXCLUDED N/A <br />UNDERINSURED <br />MOTORIST N/AINCLUDEDN/A <br />PHYSICAL DAMAGE <br />COMPREHENSIVE/ <br />COLLISION <br />N/A N/A <br />$250ESTIMATED TOTAL PREMIUM <br />N/A <br />FORMS AND ENDORSEMENTS APPLICABLE TO THIS COVERAGE PART AND MADE PART OF THIS POLICY AT THE TIME OF ISSUANCE: <br />CA 00 01 10 13, CA 01 26 10 13, CA 04 44 10 13, CA 20 54 10 13, CA 20 55 10 13, CA 23 84 10 13, CA 23 85 10 13, <br />CA 99 23 10 13, CA 99 33 10 13, CA 99 34 10 13 <br />BY <br />(AUTHORIZED REPRESENTATIVE) <br />ANI - RRG - AL <br /> "NOTICE : This Policy is issued by your risk retention group. Your risk retention group may not be subject to all <br />the insurance laws and regulations of your State. State insurance insolvency guaranty funds are not available for <br />your risk retention group." <br />THESE DECLARATIONS AND THE COMMON POLICY DECLARATIONS, IF APPLICABLE, TOGETHER WITH THE COMMON POLICY CONDITIONS, <br />COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS, IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY. <br />09/10/2020 <br />DocuSign Envelope ID: 81A61471-345A-47F9-8A2D-36F7929A6637