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t <br /> COMMERCIAL AUTOMOBILE <br /> COVERAGE PART - DECLARATIONS <br /> BUSINESS AUTO COVERAGE FORM THE 0'"' <br /> HARTFORD <br /> POLICY NUMBER: 72 UEC CK8498 <br /> This COMMERCIAL AUTOMOBILE COVERAGE PART consists of: <br /> A. This Declarations Form; <br /> B. Business Auto Coverage Form; and <br /> C. Any Endorsements issued to be a part of this Coverage Form and listed below. <br /> ITEM ONE - NAMED INSURED AND ADDRESS <br /> The Named Insured is stated on the Common Policy Declarations. <br /> ADVANCE PREMIUM: $ <br /> AUDIT PERIOD: <br /> Except in this Declarations, when we use the word "Declarations" in this Coverage Part, we mean this "Declarations" or <br /> the "Common Policy Declarations". <br /> Form Numbers of Coverage Forms, Endorsements and Schedules that are part of this Coverage Part: <br /> HA00040302 HA00120615T CA00011120 HA21020614 CA04241013 <br /> CA21541120 CA01211013 CA01430517 CA04261013 CA23441120 <br /> CA99231013 HA00240614 HA99080614 HA99161221 <br /> o„,,P244es, Risk ManagementDivisian <br /> REVIEWED&APPROVED BY: <br /> A Acevedo <br /> ®' Risk Management Specialist <br /> Form HA 00 25 12 21 / <br /> ©2021, The Hartford <br /> (Includes copyrighted material of Insurance Services Office, Inc., with its permission.) <br />