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<br />Declaration Number: 001 <br />Effective Date: U7/19/2006 <br /> <br />. ' <br /> <br />Policy Number: SBP204616-1 <br />Luis E Rivera l\ID, lnc <br /> <br />Page 7 <br /> <br />FORMS LIST <br /> <br />Forms and Endorsements Made Part of This Policy <br /> <br />Forms <br /> <br />Page <br /> <br />Common <br />BPOOm <br />61'0155 <br />RPO\OI <br />HI'0523 <br />lJP0564 <br />SEQUUU I <br />SI'QIS2X <br /> <br />l'ropert.y <br />SEQIJIJ02 <br />SEQIJIJ1J4 <br /> <br />Liability <br />BP0417 <br />BPO,I18 <br />61'0193 <br />BPI005 <br />SEQ0459 <br />SEQIJ521 <br />SEQ056I <br />SEQ2072 <br />SEQ5057 <br />SEQ6168 <br /> <br />Description <br /> <br />(0702) BU:.inessowners Coverage Fonn <br />(0702) California Changes <br />(070n Calculation of Premium <br />(1102) Cap On l.osses From Certified Acts Of Terrorism <br />(0504) Conditional Exclusion of Terrorism (Relating to Disposition of 1 iedecal Terrorism Risk Insu <br />(0104) 'I'he Enterprise Program Endorsement <br />(OgOS) BOP Coverage Extender ~ 152H <br /> <br />(0104) Equipment Breakdown Coverage <br />(0]04) Equipment Breakdown Amendment <br /> <br />(0702) Employment-Related Pradil:es E,-.;;clusion <br />(0702) Additional Insured - Designated Person or Organization <br />(0702) Total Pollution Exclusion with a Building Heating Equipment and a Hostile Fire Exceplion <br />(0702) Exclusion - Year 2000 Computer-Related and Other Electronic Problems <br />(0104) Amendment of Aggregate Limits <br />(0 I 04) Absolute Lead Exclusion <br />(OIO{) Exclusion - Designated Professional Services <br />(1204) Absolute Asbestos and Silica Exclusion <br />(0 J(4) fvfold, Fungus or Microbial Contamination Exclusion Endorsement <br />(0305) Exclusion - Violation of statutes that govern e-mails, fax, phone calls or other methods of se <br /> <br />lnlaml Marine <br />SFQ0410 (0 I (4) Transit Coverage <br /> <br />L___ <br /> <br />Date Printed 07125/2006 <br /> <br />8 <br />'55 <br />59 <br />60 <br />61 <br />65 <br />6X <br /> <br />75 <br />81 <br /> <br />82 <br />83 <br />84 <br />85 <br />86 <br />87 <br />88 <br />89 <br />90 <br />91 <br /> <br />92 <br /> <br />INSURED <br /> <br />BOP FormILiSl-' <br />