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<br />Policy Number Policy Period <br />From To <br />Coverage is Provided in the Agency Code <br />Named Insured and Address Agent <br />Policy Period:Beginning and Ending at 12:01 a.m.Standard Time at the Location of the Described Premises. <br />Business Type: <br />Mortgagee/Loss Payable: <br />Business of the Named Insured: <br />In consideration of the premium,insurance is provided the Named Insured with respect to those premises described in the <br />Schedule below and with respect to those coverages and kinds of property for which a specific Limit of Insurance is shown, <br />subject to all of the terms of this policy including forms and endorsements made a part hereof: <br />LOCATION SCHEDULE <br />Described Premises: <br />SECTION I - PROPERTY LIMITS OF INSURANCE <br />Loc No Bldg No Loc No Bldg No Loc No Bldg No <br />Deductible Amount $$$ <br />Building Amount <br />Valuation <br />Business Personal <br />Property Valuation <br />Business Income <br />Business Income <br />Waiting Period <br />Excluded /None /24 hours /48 hours /72 hours <br />SECTION II - LIABILITY <br />Liability and Medical Expenses Limit $Per Occurrence $Aggregate <br />Medical Expenses $Each Person <br />Damage to Premises Rented to You $ <br />Date Issued:Payment Type: <br />LIMITS OF INSURANCE <br />All Perils <br />391-1002 08 16 Page 1 of 2 <br />4. <br />Liability and Medical Expenses Limits of Insurance: <br />Except for Damage to Premises Rented to You, each paid claim for the following coverages reduce the Amount of Insurance we <br />provide during the applicable annual period. Please refer to SECTION II - LIABILITY, D. LIABILITY AND MEDICAL EXPENSES <br />LIMITS OF INSURANCE, paragraph. of the Businessowners Coverage Form. <br /> AVENUES BUSINESSOWNERS DECLARATION <br /> BUSINESSOWNERS RENEWAL DECLARATIONS <br />32 <br />RENEWAL OF OD6 A005679 <br /> <br />OD6-A005679-07 06/25/2020 06/25/2021 MASSACHUSETTS BAY INSURANCE COMPANY 190282000 <br />TRIANGLE UROLOGY ASSOCIATES, <br />ATTN: DAVIN <br />205 FRASIER ST. <br />DURHAM, NC 27704 <br />919-781-0200 <br />ASSUREDPARTNERS OF NC LLC <br />CL HANOVER CSC/STE 350 <br />4505 FALLS OF NEUSE RD <br />RALEIGH, NC 27609 <br />CORPORATION (SINGLE). <br />SEE ADDITIONAL INTEREST SCHEDULE <br /> <br /> <br /> <br />OFFICE, SERVICE. <br /> <br />NO. 001 001 205 FRASIER ST., DURHAM, NC 27704 <br />NO. 002 001 10321 LUMLEY RD. # 201, RALEIGH, NC 27617 <br />NO. 003 001 101 CONNER DRIVER, SUITE 201, CHAPEL HILL, NC 27514 <br />(SEE FORM 391-1013 FOR ADDITIONAL PREMISES.) <br />001 001 002 001 003 001 <br /> 1,000 1,000 1,000 <br />NOT COVERED <br /> <br />NOT COVERED <br /> <br />NOT COVERED <br /> <br /> 596,176 <br />RC <br /> 143,082 <br />RC <br /> 208,372 <br />RC <br />ACTUAL BUSINESS LOSS SUSTAINED NOT EXCEEDING 12 CONSECUTIVE MONTHS <br />48 HOURS <br />1,000,000 2,000,000 <br /> 10,000 <br /> 500,000 <br />04/21/2020 ORIGINAL/INSURED DIRECT BILL <br /> <br /> <br />$$$ <br />DocuSign Envelope ID: F746D5BF-EF42-497A-9B83-D263FC4E623D