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Capitol Specialty Insurance Corp <br />P.O. Box 5900, Madison, WI 53705 COMMERCIAL GENERAL LIABILITY <br />COVERAGE PART DECLARATIONS <br />RENEWAL OF NUMBER: New <br />POLICY NUMBER POLICY PERIOD AGENCY <br />BR01292559 03/26/2009 03/26/2010 04608 <br />12:01 A.M. Standard Time at the address of the insured stated herein <br />NAMED INSURED AND ADDRESS AGENT <br />EARTHTECK INTERNATIONAL CORP BASS UNDERWRITERS INC <br />PO Box 48259 20350 VENTURA BLVD, SUITE 120 <br />Los Angeles, CA 90048-0259 Woodland Hls, CA 91364 <br />(Los Angeles CTY) <br />General Aggregate Limit $i, ooo <br />ooo <br />(Other Than Products-Completed Operations) , <br />Products-Completed Operations Aggregate Limit $1, ooo, ooo <br />Personal and Advertising Injury Limit $i, ooo, ooo <br />Each Occurrence Limit $i, ooo <br />ooo <br />Damage To Premises Rented To You Limit , <br />$ loo, ooo Any One <br /> <br />Medical Expense Limit <br />$ s, ooo Fire <br />Any One <br /> Person <br />BUSINESS DESCRIPTION AND LOCATION OF PREMISES <br />Form of Business: CORPORATION <br />Business Description: AMRKET/SALES OF EBERGY SAVING DEVICE <br />Location of All Premises You Own, Rent or Occupy: <br />SEE ATTACHED LOCATION SCHEDULE, FORM # CICG 176 <br />PREMIUM <br />Code Premium Rate Advance Premium <br />Classification No. Basis Pr/Co Other Pr/Co Other <br />SEE ATTACHED COMMERCIAL GENERAL LIABILITY SCHEDULE #CICL 043 <br />Total Advance Premium $ 5, o4s <br />* THE LIABILITY PREMIUM BASIS OF THIS POLICY IS SUBJECT TO AN AUDIT. <br />ADDITIONAL PREMIUM MAY BE DUE. <br />FORMS AND ENDORSEMENTS: SEE COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />FORM SCHEDULE #CICL 044 <br />COUNTERSIGNED 04/21/2009 gy <br />Authorized Representative <br />CICL 042 (07-08) <br />Insured Copy <br />