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Policy Number Policy Period <br />From To <br />Coverage is Provided in the Agency Code <br />Named Insured and Address Agent <br />Additional Property Coverages and Extensions: <br />See attached Schedule for Additional Coverages provided for under this Policy. <br />Additional Liability Coverages: General Liability Broadening Endorsement <br />General Liability Class: <br />Description: <br />Liability Exposure: <br />Policy Forms, Endorsements and Optional Coverages Attached: <br />See Forms and Endorsements Schedule <br />Countersigned this ____ Day of ________________________________________________________ <br />Authorized Representative <br />This Declarations Page with the Policy Contract, Forms and Endorsements, if any, <br />Complete the Policy. <br />391-1002 08 16 Page 2 of 2 <br />Date Issued:Payment Type: <br /> BUSINESSOWNERS DECLARATION <br /> BUSINESSOWNERS AMENDED DECLARATIONS EFFECTIVE 01/05/2023 NUMBER 02 <br />32 <br />SUPERSEDES ANY PREVIOUS DECLARATIONS BEARING THE SAME NO. FOR THIS POLICY PERIOD <br />AMENDED LOC ADDRESS <br />OZ6-H175809-03 01/05/2023 01/05/2024 THE HANOVER AMERICAN INSURANCE COMPANY 190290900 <br />CHAPEL HILL - CARRBORO CHAMBER <br />OF COMMERCE <br />104 S. ESTES DRIVE STE 102 <br />CHAPEL HILL, NC 27514 <br />919-636-3252 <br />TITAN RISK CONSULTANTS <br />107 CONNER DR STE 225 <br />CHAPEL HILL, NC 27514 <br /> <br /> <br />85265 <br />CHAMBERS OF COMMERCE <br /> <br /> <br /> <br />PREVIOUS PREMIUM IS: $2,352 <br />NET PREMIUM CHANGE IS: $0 <br />TOTAL BOP COVERAGE PREMIUM: $1,327.00 <br />BOP TERRORISM COVG (INCLUDED IN TOTAL POLICY PREMIUM) $ 30.00 <br /> OTHER THAN FIRE FOLLOWING $ 12.00 <br /> FIRE FOLLOWING $ 18.00 <br />TOTAL UMBRELLA COVERAGE PREMIUM: $1,025.00 <br />UMB TERRORISM COVG (INCLUDED IN TOTAL POLICY PREMIUM) $ 25.00 <br />THE TOTAL ACTUAL PREMIUM: $2,352.00 <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />02/13/2023 ORIGINAL/INSURED DIRECT BILL <br />DocuSign Envelope ID: 0394510E-E3BC-41FC-9E39-4912EB106E3B