# Commercial General Liability Declarations

**CHUBB**

**ACE American Insurance Company**
436 Walnut Street
Philadelphia PA 19106

**POLICY NUMBER:** HDO G27865355

| Endt. No. | Form No. | Description |
|-----------|----------|-------------|
| 72        | CG20370413 | Additional Insured – Owners, Lessees Or Contractors – Completed Operations |
| 73        | CG20100413 | Additional Insured – Owners, Lessees Or Contractors – Scheduled Person Or Organization |
| 74        | CG20100413 | Additional Insured – Owners, Lessees Or Contractors – Scheduled Person Or Organization |
| 75        | CG20100413 | Additional Insured – Owners, Lessees Or Contractors – Scheduled Person Or Organization |
| 76        | CG20100413 | Additional Insured – Owners, Lessees Or Contractors – Scheduled Person Or Organization |
| 77        | CG20100413 | Additional Insured – Owners, Lessees Or Contractors – Scheduled Person Or Organization |
| 78        | CG20100413 | Additional Insured – Owners, Lessees Or Contractors – Scheduled Person Or Organization |
| 79        | CG20100413 | Additional Insured – Owners, Lessees Or Contractors – Scheduled Person Or Organization |
| 80        | CG20100413 | Additional Insured – Owners, Lessees Or Contractors – Scheduled Person Or Organization |
| 81        | CG20100413 | Additional Insured – Owners, Lessees Or Contractors – Scheduled Person Or Organization |
| 82        | CG20100413 | Additional Insured – Owners, Lessees Or Contractors – Scheduled Person Or Organization |
| 83        | CG20100413 | Additional Insured – Owners, Lessees Or Contractors – Scheduled Person Or Organization |
| 84        | CG20100413 | Additional Insured – Owners, Lessees Or Contractors – Scheduled Person Or Organization |
| 85        | CG20100413 | Additional Insured – Owners, Lessees Or Contractors – Scheduled Person Or Organization |
| 86        | CG20150413 | Additional Insured – Vendors |
| 87        | CG24220413 | Amendment Of Coverage Territory – Worldwide Coverage |
| 88        | CG24171001 | Contractual Liability – Railroads |
| 89        | CG21471207 | Employment-Related Practices Exclusion |
| 90        | CG22750413 | Professional Liability Exclusion – Computer Software |
| 91        | CG22880413 | Professional Liability Exclusion – Electronic Data Processing Services And Computer Consulting Or Programming Services |
| 92        | CG24040509 | Waiver Of Transfer Of Rights Of Recovery Against Others To Us |
| 93        | CG24040509 | Waiver Of Transfer Of Rights Of Recovery Against Others To Us |
| 94        | LD380420712 | Stop Gap – Employers Liability Coverage Endorsement – Puerto Rico Supplementary Payments 100% Borne By Insured |
| 95        | LD316620811 | Vermont Changes - Pollution |
| 96        | IL02581214 | Arizona Changes – Cancellation And Nonrenewal |
| 97        | CG01420711 | Arkansas Changes |

**LD-25211 (10/08)**

*Copyright, Insurance Services Office, Inc. 2000*

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