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02/03/2005 14:34 7145714209 PARKS AND RECREATION PAGE 05 <br />.V1/11/2VU5 14. Uf fAA IrVo404JaV4 Aubunu lneunn11u1 u.uu v <br />J k $COrfSDALE INSURANCE COMPXNYm <br />COMMERCIAL GENERAL UABILITY COVERAGE PART <br />SUPPLEMENTAL DICLARATIONS <br />Them 9uppMmerlral Oedareeoee torn a part of polloy number at■ Selo,,, Sea _ <br />L pri OP eYBURANCB <br />I,QaMMW Aeprepate Lanit Mther Then PNadUaMC lirplero Operslene) ; a, ■aa,000 <br />Products -Completed 00eretlona Aggregate LWM : l.sss.00e <br />Personal and Adrerlreing Injury Limit <br />(Bach Odowrerde Limit a 1_wo,00v <br />e sv, Doc any one fln <br />'FiroOamepeLlmk - - <br />� �1 600600 any One person <br />!Msdlml Expense Limo — <br />MUaINEea CGSCRPrnON AND LOCIAMON OP Pa ISES <br />FormerBudneee <br />Indlvldwl U jofil VOnlun = Parulenhlp Cerperarion rower Sun P■MYM4p o• Jorn Wmuro) ii <br />Rua!neseDescription; aer coos <br />Location of All PWnbas You 00. ROM or Occupy: <br />70I a. 4PneP aTRM• VWMA amr Ch 12704 <br />-- <br />PIRMWM <br />Prerrdum <br />! pOpmae7an Code No. ' Premlwe Mole PdCa All OSrar PrICO All Olr r <br />I Wj Casa mmose Meer anN Now walk gar19 4171e o)Mlk MINIM 7t a ;PCL 3 Mas#. <br />rnommi/dtllL 070s wn eta 91"1es" 1O <br />i Tell auesseeM eormmraa r xt <br />AMMOML immm mow. look FULLY sham <br />l <br />1 lee. set. <br />i <br />Tessa Ye Mou 1100, j <br />PoalMi AND lNDOII emT (t)Btar than, applicable firms and enoonownse shown swewhsre In tine policy) <br />Fennoand&WOM M4MYM1M10tlrhLbwspePeriandmad■putofehNPelb►ratereelseernr <br />SAM as per EsplrWB PNey <br />•,(a) Ama,(c) Tatar Cost (m) Admlaaion, (p) Payroll, (a) Grose Bela, (u)LInite. (0) Other <br />THIS aUPPLEMENTA4 DECLARATIONS AND THE COMMERCIAL LIABILITY DECLARATIONS, TO(iEINER WITH THE <br />COMMON POLICY CONDITICNa, COVERAGE FORM(S) AND ENDORSEMENTS COMPLETE THE ABOVE NUMBERED <br />POLICY <br />CLe4&11(2AQ <br />