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NEW <br />Renewal of Number <br />POLICY DECLARATIONS <br />No. SE 2022545 <br />Mount Vernon Fire lnsurance Company <br />1190 Devon Park Drive, Wayne, Pennsylvania 19087 <br />A Member Company of United States Liability lnsurance Group <br />NAMED INSURED AND ADDRESS: <br />BARBARA DAVIDSON <br />DBA: EASTON MEMORIAL DAY <br />SHOW <br />PO BOX 698 <br />EASTON, WA 98925 <br />PARADE AND CAR <br />POLICYPERIOD: (MO. DAYYR.) From: 0512412024 To: 0512712024 <br />FORM OF BUSINESS: <br />BUSINESS DESCRIPTION: Special Event <br />This contract is registered and delivered as a surplus line <br />coverage under the insurance code of the state of <br />Washington, Title 48 RCW. lt is not protected by any <br />Washington state guaranty association law. <br />y#i# {, M*rg <br />12:01 A.M. STANDARD TIME AT YOUR <br />MAILING ADDRESS SHOWN ABOVE <br />THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED. <br />THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT. <br />Commercial Liability Coverage Part <br />PREMIUM <br />$660.00 <br />Wholesaler Broker Fee <br />Surplus Lines Tax <br />Stamping Fee <br />TOTAL: <br />$75.00 <br />$14.70 <br />$0.74 <br />$7s0.44 <br />Coverage Form(s) and Endorsement(s) made a part of this policy at time of issue <br />See Endorsement EOD (1/95) <br />IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE <br />WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. <br />Agenl: TAPCO- KL (5576) (5576) <br />PO Box 286 <br />Burlington, NC 27216 <br />Broker: Lael lnsurance& Financial Services <br />2301 W Dolarway Rd Ste 5 <br />Ellensburg, 98924 <br />lssued: 0312812024 7:57 AM <br />\$d"-- <br />By: <br />THESE DECLARATIONS TOGETHER WITH THE COMMON/POLICY CONDITIONS, COVERAGE PART DECLARATIONS, <br />I rDn /na_^7\ covERAGE PART COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS' tF ANY' TSSUED TO FORM A PART THEREOF'VI U \V,-V' / COMPLETE THE ABOVE NUMBERED POLICY, <br />Authorized