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Personal Umbrella Policy Declarations <br />Policy number: 1811389971I <br />Policy effective date: December 29, 2022 <br />Coverage <br />Employers' Liability - if Workers' Compensation or <br />similar coverage for Domestic Workers is required <br />or purchased voluntarily <br />Page 3 of 3 <br />Allstate.. <br />Required Underlying Limit <br />$300,000 each occurrence <br />$300,000 each employee <br />$500,000 policy aggregate <br />Your policy documents <br />Your Personal Umbrella policy consists of the Policy Declarations and the following documents. Please keep them together. <br />• Personal Umbrella Policy - AS400 • Minnesota Personal Umbrella Policy Amendatory <br />Endorsement - AS429-1 <br />Important payment and coverage information <br />Here is some additional, helpful information related to your coverage and paying your bill: <br />► Please note: This is not a request for payment. Any adjustments to your premium will be reflected on your next scheduled <br />bill which will be mailed separately. <br />Allstate Indemnity Company's Secretary and President have signed this policy with legal authority at Northbrook, Illinois. <br />Llaca,,-Azo <br />William Hill Susan L. Lees <br />President Secretary <br />MN088NBD 02/22 <br />