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Capitol Specialty Insurance Corp <br />P.O. Box 5900, Madison, WI 53705 <br />LOCATIONS SCHEDULE <br />POLICY NUMBER POLICY PERIOD AGENCY <br />BR01292559 03/26/2009 03/26/2010 04608 <br />NAMED INSURED AND ADDRESS AGENT <br />EARTHTECK INTERNATIONAL CORP <br />PO Box 48259 BASS UNDERWRITERS INC <br />Los Angeles, CA 90048-0259 <br />(Los Angeles CTY) <br />Prems. <br />No. Street City St. Zip <br />001 805 S Atlantic Blvd Apt 5 Alhambra CA 91803 <br />Los Angeles <br />CICG 176 (10-93} Insured Copy <br />