# Comprehensive General Liability Insurance Coverage Schedule

**Policy No.:** 06-60-700  
**Effective Date:** [Not specified]  
**Agency No.:** [Not specified]

## Location of All Premises Owned by, Rented to or Controlled by the Named Insured in Such Premises

- **Owner:** [Not specified]
- **General Lessee:** [Not specified]
- **Tenant:** [Not specified]

## Part Occupied by Named Insured

- **As per Schedules in Company Files**
- **As per Schedules in Company Files**
- **As Necessary**

## Description of Hazards

| Description of Hazards | Code No. | Premium Bases | Rates | Advance Premiums |
|------------------------|----------|---------------|-------|------------------|
| Premises—Operations    |          |               |       |                  |
| (a) Area (sq. ft.)     |          |               |       |                  |
| (b) Premises           |          |               |       |                  |
| (c) Remuneration       |          |               |       |                  |

## Escalators (Number at Premises)

- **As per Schedules in Company Files**

## Independent Contractors

- **As per Schedules in Company Files**

## Completed Operations

- **As per Schedules in Company Files**

## Products

- **As per Schedules in Company Files**

## IBM 062354

**Total Advance Premium:** $ [Not specified]

The foregoing discloses all hazards insured hereunder known to exist at the effective date of this policy, unless otherwise stated herein.

(Continued on reverse side)