# Commercial General Liability Declarations

**CHUBB**

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

**POLICY NUMBER:** HDO G48898919

| Endt. No. | Form No. | Description |
|-----------|----------|-------------|
| 40        | MS136320513 | Blended Pollution Exclusion |
| 41        | MS136230517 | Bodily Injury Definition Extension |
| 42        | MS379580517 | Electronic Chat Rooms Or Bulletin Boards Endorsement |
| 43        | MS300450518 | Employee Benefits Liability Endorsement |
| 44        | MS31549320521 | Personal And Advertising Injury Definition Extension |
| 45        | MS136270518 | Property Damage |
| 46        | MS136310518 | Recall Of Products, Work Or Impaired Property |
| 47        | MS3449980522 | Specified Area Exclusion Endorsement |
| 48        | MS30833720920 | Waiver Of Governmental Immunity |
| 49        | MS136290519 | Who Is An Insured Amendment |
| 50        | IL09851220 | Disclosure Pursuant To Terrorism Risk Insurance Act |
| 51        | CG20261219 | Additional Insured – Designated Person Or Organization |
| 52        | CG20261219 | Additional Insured – Designated Person Or Organization |
| 53        | CG20261219 | Additional Insured – Designated Person Or Organization |
| 54        | CG20261219 | Additional Insured – Designated Person Or Organization |
| 55        | CG20261219 | Additional Insured – Designated Person Or Organization |
| 56        | CG20261219 | Additional Insured – Designated Person Or Organization |
| 57        | CG20261219 | Additional Insured – Designated Person Or Organization |
| 58        | CG20261219 | Additional Insured – Designated Person Or Organization |
| 59        | CG20261219 | Additional Insured – Designated Person Or Organization |
| 60        | CG20261219 | Additional Insured – Designated Person Or Organization |
| 61        | CG20261219 | Additional Insured – Designated Person Or Organization |
| 62        | CG20261219 | Additional Insured – Designated Person Or Organization |
| 63        | CG20261219 | Additional Insured – Designated Person Or Organization |
| 64        | CG20261219 | Additional Insured – Designated Person Or Organization |
| 65        | CG20261219 | Additional Insured – Designated Person Or Organization |
| 66        | CG20261219 | Additional Insured – Designated Person Or Organization |
| 67        | CG20261219 | Additional Insured – Designated Person Or Organization |
| 68        | CG20261219 | Additional Insured – Designated Person Or Organization |
| 69        | CG20261219 | Additional Insured – Designated Person Or Organization |
| 70        | CG20261219 | Additional Insured – Designated Person Or Organization |
| 71        | CG20261219 | Additional Insured – Designated Person Or Organization |
| 72        | CG20261219 | Additional Insured – Designated Person Or Organization |
| 73        | CG20261219 | Additional Insured – Designated Person Or Organization |
| 74        | CG20281219 | Additional Insured – Lessor Of Leased Equipment |
| 75        | CG20111219 | Additional Insured – Managers Or Lessors Of Premises |

**LD-25211 (10/08)**
Copyright, Insurance Services Office, Inc. 2000
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