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<br />" '\PI\'"~~-99 04: Z7P <br />-'.' ... <br /> <br />urJZ~'1~99 10:35 <br /> <br />71A-571-4235 <br /> <br />. <br /> <br />REG"'EA TI N ,~ GO/1r- SVS <br /> <br />. <br /> <br />D{'GE IJ5 <br />P,03 <br /> <br />This r.ndol'SemCl1t chal1ges dIe Commereialliability Policy. PLEASE read it ~refu"y. <br /> <br />Th,. ~"'l. lIffi:eli.c... 041Ol11!l9 at SI-..,_ Ih,,- i~ tile Polk" Dee)."..:""... r-. . pQrl of Polley Number <br />IYG332~6OC-9. ia....d to PDicr Manico..e l0377819lly a_II Slulnck:mnily. <br /> <br />Ii.........."" NU"ber UII I <br /> <br />Thie ~I mooJiiloo bosor~ pro,iIkd f.... WllIor Ihe folbwiftg: <br /> <br />COMMlUlCII\.L GIlNEILU. LIABILITY COVERAGE I"^RT <br /> <br />ADDrTrOIlfAL rNSVUD - BLA.l'Oa!T FORM <br /> <br />WHO IS AN INSlIRED (Section If) i. IIIllCndcd to iocltodc .. 8ft in.""", Ibe pc;rIOIJ{sj Of' OI'pIlillNi<Ml(s) .bOWlt i.. lire <br />!loIl<<l.llo.. on ,"...rc:d bill Ohl}' will. "")1<:0111> li~;lily lIIioio..... ofyouroP'''.'ioo. 'If "",roi",. ....",.,d by or ""'1<<1 to <br />""". <br /> <br />.Hlmr of ~ .... Orpa/aMlon <br /> <br />CItj1 '" s..... ~.. It<<............ <br />" eo"""."'f)' Sa-m.,. Aatu.,. <10 o..nte Shw _ W S...t. ,AI... R/WI. <br />ll.... Aft.. CA 92'U2 <br /> <br />All eertlficlI", of in'urance holders )1011 hll\le aareed to ilJ<;Jude ... an imrured priOf /(l an "occ,,,rCfl<:<!" Of pffell$e <br /> <br />(1-91) <br /> <br />AS 'IO i'Otl.M <br />APP1l0'lED ~ <br />t!;iu; f. ~ ~" <br />~ISA E. "'ftt1tf'IIII <br />....1It CItV <br /> <br />