Seaboard Surety Company

HOME OFFICE: NEW YORK, N. Y.

DECLARATIONS

Policy No. DN 10189

Item A	Organization (The Organization) Swanson Center for Nutrition, Inc. Principal Address 8401 West Dodge Road Omaha, Nebraska 68114
Item B	Policy Period: May 1, 1975 to: May 1, 1978 12:01 A.M. Standard Time At The Principal Address Stated in Item A.

This Declaration page is issued on conjunction with and forms part of the Directors, Officers and Trustees Liability and Organization Reimbursement Policy and along with the completed and signed Application form shall constitute the contract between Directors, Officers, Trustees and the Organization and the Insurer.

Item C	Limit of Liability: $ 3,000,000	each policy year
Item D	Retention: $ 2,500	each loss
Item E	Premium: $ 3,147	Minimum Three Year Premium $ 2,500
Item F	Notice of claim (Paragraph VII) to the Insurer General Counsels Office Seaboard Surety Company 90 William Street New York, New York 10038
Item G	This policy does not provide coverage for the following positions: (Absence of entry means no exception)

Item H Form numbers of endorsements attached at issuance:

Form No. 6210 - Endorsement No. 1

IRVINE INSURANCE AGENCY, INC.

Countersigned by

Authorized Agent

Form 516 D

Source: https://www.industrydocuments.ucsf.edu/docs/nlvw0228