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DocuSign Envelope ID:DF078B63-CCED-42B9-8016-A67D8F6DF779 COMMERCIAL PACKAGE POLICY <br /> BUILDERS PREMIER INSURANCE CO. FORM INVENTORY SCHEDULE <br /> Post Office Box 150005 Policy Number: PCP 0000055 13 <br /> Raleigh, North Carolina 27624-0005 Named Insured: BROWN BROTHERS PLUMBING <br /> Agent: DIVERSIFIED INSURANCE SOLUTION 0000443 <br /> POLICY FORMS SCHEDULE <br /> Policy Level Forms <br /> Commercial Fire Forms <br /> CP0010 (04/02) CP0030 (04/02) CP0090 (07/88) CP0118 (10/00) CP1030 (04/02) <br /> CP1075 (12/20) CP1218 (06/95) CP9903 (12/19) EM0001 (07/08) IL0003 (07/02) <br /> IL0017 (11/98) IL0269 (07/02) IL0935 (07/02) IL0952 (01/15) IL0995 (01/07) <br /> IL6006 (01/10) IL6014 (01/16) PIL002ONC (07/04) <br /> General Liability Forms <br /> CG0001 (04/13) CG0300 (01/96) CG2001 (04/13) CG2010 (04/13) CG2032 (04/13) <br /> CG2037 (04/13) CG2038 (04/13) CG2107 (05/14) CG2109 (06/15) CG2147 (12/07) <br /> CG2149 (09/99) CG2154 (01/96) CG2167 (12/04) CG2170 (01/15) CG2186 (12/04) <br /> CG2187 (01/15) CG2196 (03/05) CG2294 (10/01) CG2404 (05/09) CG2503 (05/09) <br /> CG2504 (05/09) CG7024 (03/09) CG7030 (07/09) CG7031 (07/09) CG7032 (07/09) <br /> CG7034 (07/09) CG7051 (06/15) CG7110 (10/17) CG7137 (10/17) IL0003 (09/08) <br /> IL0017 (11/98) IL0021 (09/08) IL0269 (09/08) IL1201 (11/85) IL6006 (01/10) <br /> Inland Marine Forms <br /> CM0001 (06/95) CM0103 (11/85) CM9905 (12/19) IL0003 (04/98) IL0017 (11/98) <br /> IL0269 (04/98) IL0935 (08/98) IL0952 (01/15) IL0995 (01/07) PCM0018 (10/99) <br /> PCM0023 (03/02) PCM0042 (07/04) <br /> Issued Date: 11/29/2021 <br /> SCHED 0696 INSURED COPY Page 40 of 40 <br />