General Liability Exclusion
Applicant Name
Broker Name
The following coverages are excluded from this policy:

Products Liability

Completed Operations

Personal Injury

Advertising Injury

Professional Liability
In addition, coverage will be limited to the premises listed on the Designated Premises
Endorsement.
I have reviewed with my broker the policy and listed endorsements being offered by Lancer
Indemnity Company.
Applicant Signature
Date
Broker Signature
Date