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capitol Specialty Insurance Corp <br />P.O. Box 5900, Madison, WI 53705 <br />ADDITIONAL INTEREST SCHEDULE <br />POLICY NUMBER POLICY PERIOD AGENCY <br />BR01292559 <br />03/26/2009 03/26/2010 <br />04608 <br />rvHm~u irvsuKtu AND ADDRE55 AGENT <br />EARTHTECK INTERNATIONAL CORP <br />PO Box 48259 BASS UNDERWRITERS INC <br />Los Angeles, CA 90048-0259 <br />(Los Angeles CTY) <br />LIABILITY: <br />Additional Insured <br />CITY OF SANTA ANA <br />20 Civic Center Plz <br />Santa Ana, CA 92701-4058 <br />CG2010 - CA - Loc #1 -ADDITIONAL INSURED FLAT RATE -FULLY EARNED <br />CGE 067 (08-03) Insured Copy <br />