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<br />II!!!! <br /> <br />...-- <br /> <br />...... <br />= <br />!!! <br />= <br /> <br />- <br />- <br />- <br />¡¡¡; <br />- <br />- <br />æ <br />- <br />- <br />= <br />- <br />iii <br />iii <br />- <br />- <br />!!!!! <br />= <br />- <br />- <br />55 <br />;¡¡¡¡¡¡¡¡ <br /> <br />!S. <br /> <br />05/13/2003 10: 08 3105455478 ED CAP"IELIAN ~HD ~AGE 01 <br /> <br />. . 08 This 8pectnIm Policy colts of the Declarations, Coverage Form6, com!n Policy Conditions and any <br />67 other Forms and Endorsements issued to bB a part of the Policy. Thl61neurance hi provided by the insurance <br />CK company 01 ThB Hartford Insurance Group shown below. <br />SBA <br /> <br />INSURER: HARTFORD CASUALTY INSURANCE COMPANY <br />HARTFORD PLAZA, HARTFOI'.D, CT 06115 <br />COMPJ\IIIY CODE: 3 <br /> <br />'\' <br />í <br /> <br />Ii I <br />(, I <br /> <br />/ <br /> <br />Policy Number: 72 SBA CK6708 <br /> <br />DX <br /> <br />~l <br /> <br />SPECTRUM POUCY DECLARATIONS <br /> <br />ORIGINAL <br /> <br />... <br />'" <br />'" <br />... <br />.... <br /> <br />Nam8cllll8Ul1lCl8nd M81lIng Acid_: <br />(No., Street, Town, 51818, Zip Code) <br /> <br />EDWARD CAPIUBLIAN <br /> <br />... <br />'" <br />..... <br />'" <br />'" <br />'" <br />... <br />;;¡ <br />u <br />'" <br />... <br />'" <br />'" <br />'" <br />..... <br />Z' <br /> <br />613 DRD STREET <br />MANHATTAN BJW:H <br /> <br />CA <br /> <br />90266 <br /> <br />Policy P8rIod: From 03/06/03 To 03/06/04, 1 YEAR <br />12;01 a.m.. Standard tlmB at your maUlng eddress shown above. ExO8PlIon: 12 noon in Maine, Michigan, New Hampshire, <br />North Carolina. <br /> <br />N8II1. of ~rokw: GROSSLIGHT INS/SCIC <br />Code: 250765 <br /> <br />Pl'8viouel'o\Jcy Number: 72 SBA Clt67 0 8 <br /> <br />Nemed In8urM 18: INDIVJ:DUAL <br /> <br />AudIt P8rIod; NON-AUDITABLE <br /> <br />Type of Proper1y Co--s¡e: SPECIAL <br /> <br />iMuran.. Provtd8d: In rgtum for 1118 paymønt 01 the prømlum and subject to aU 01 tha terms 01 this policy, we agAle <br />with you to provide insurance as IIalød In thll policy. <br /> <br />TOTAL ANNUAL PREMIUM 88: <br /> <br />$3,316 <br /> <br /> <br />,---,,-"--'-'-"'--'" <br /> <br />AP¡'lZ()\ <br /> <br />iU ¡ORi'!. <br /> <br /> <br />---.---.... <br /> <br />CA SURCHARGE: <br /> <br />66.32 <br /> <br />Count8rølgnød by <br /> <br />~Cil~ <br />Authoriled Rup_ntative <br /> <br />14124,/02 <br />0... <br /> <br />Form &S GO 0211 . T Printød in U.S.A. INS) <br />'"'-sa DId8: 12/24/02 <br /> <br />Page 001 (CONTINUED ON NEXT PAGE) <br />Pallcy EIIpIntion D*: 03/06/04 <br /> <br />INSURED COPT <br />