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CPD-PIIC-CW (02/21) <br />Includes copyrighted material of Insurance Services Office, Inc., with its permission. <br />Philadelphia Indemnity Insurance Company <br />A Stock Company (Nonparticipating) <br />Policy Number: <br />COMMON POLICY DECLARATIONS <br />Named Insured and Mailing Address: Producer: <br />Policy Period From:To:at 12:01 A.M. StandardTimeat yourmailing <br />addressshown above. <br />Business Description: <br />IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TOALLTHE TERMS OF THIS <br />POLICY, WE AGREEWITHYOUTO PROVIDE THE INSURANCE AS STATED INTHIS POLICY. <br />THIS POLICY CONSISTS OF THE FOLLOWINGCOVERAGE PARTS FORWHICH A PREMIUM IS <br />INDICATED. THIS PREMIUM MAY BE SUBJECTTO ADJUSTMENT. <br />Commercial Property Coverage Part <br />Commercial General Liability Coverage Part <br />Commercial Crime Coverage Part <br />Commercial Inland Marine Coverage Part <br />Commercial Auto Coverage Part <br />Businessowners <br />Workers Compensation <br />PREMIUM <br />Total <br />PHPK2668936-023 <br />112290 <br />(919)636-3252 <br />05/10/2026 <br /> 4,269.00 <br /> 386.00 <br />$ 14,529.00 <br />Non Profit Organization <br />Titan Risk Consultants, LLC <br />107 Conner Drive <br />Suite 225 <br />Chapel Hill, NC 27514 <br />05/10/2025 <br /> 2,663.00 <br /> 55.00 <br />Sexual/Physical Abuse 1,831.00 <br />Charles House Association <br />7511 Sunrise Rd <br />Chapel Hill, NC 27514-9718 <br /> 5,380.00Professional Liability <br />Total Includes Federal Terrorism Risk Insurance Act Coverage <br />Docusign Envelope ID: 1C9A203A-0EA3-49EF-9D03-68616A08D67A