Dominion Insurance Services: Where the Answers Are
370 Park Street, Suite 8, Moraga CA. 94556
341 S. Main, Suite 100, Alpine UT. 84004
888.313.9977(t) ~ 925.313.9978(f)
info@dominioninsurance.com
dominion-insurance.com

Manuscript Endorsement for Exclusion of Specified Subjects

In consideration of the premium for which this Policy is written, it is hereby understood and agreed that this Policy does not apply to: any work performed by or on behalf of, any Claim made by or relating to, or any circumstance involving, any of the following individuals, clients, claimants, entities, estates or trusts:

Any work, any Claim or any circumstance arising out of, relating to or involving any subject listed above is excluded, in its entirety, from coverage under this Policy.

All other terms and conditions of the Policy remain unchanged.

Manuscript Exclusion Endorsement (04/23)