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ADDITIONAL. COVERAGES <br />Ref # <br />Description <br />Coverage Code <br />Form No Edition Date <br />Policy Fee <br />POLFE <br />Limit 1 <br />Limit 2 <br />Limit 3 <br />Deductible Amount <br />Deductible Type <br />Premium <br />Ref # <br />Description <br />Coverage Code <br />Form No. Fdition Date <br />Hired Auto <br />HRDBB <br />Limit 1 <br />limit 2 <br />Limit 3 <br />Deductible Amount <br />Deductible Type <br />Premium <br />1,000,000 <br />Ref # <br />Description <br />Coverage Code <br />Form No. Edigon Date <br />Non -owned <br />NOWND <br />Limit 1 <br />Limit 2 <br />Limit 3 <br />Deductible Amount <br />Deductible Type <br />Premium <br />1 ,000,000 <br />Ref # <br />Description <br />XCYBR <br />Coverago Coda <br />XCYBR <br />Form No. <br />idition Date <br />Limit 1 <br />Limit <br />Limit 3 <br />Deductible Amount <br />Deductible Type <br />Premium <br />Ref # <br />Description <br />Coverage Code <br />I <br />Form No. Edition Date <br />STSR7 <br />STSR7 <br />Limit 1 <br />Limit 2 <br />Limit 3 <br />Deductibla Amount <br />Deductible Type <br />Premium <br />$2.00 <br />Ref # <br />Description <br />Coverage Code <br />Form No. Edition Dato <br />Fraud Fee <br />FI�AU❑ <br />Limit 1 <br />Limit 2 <br />Limit 3 <br />Deductible Amount <br />Deductible Type <br />Premium <br />$4.00 <br />Ref # <br />Description <br />Coverage Code <br />Form No. Edition Date <br />Assessment Fund <br />ASIViNT <br />Limit 1 <br />Limit 2 <br />Limit 3 <br />Deductible Amount <br />Deductible Type <br />Premium <br />$13,00 <br />Ref # <br />Description <br />Coverage Code <br />Form No. <br />Edition Date <br />Expense constant <br />EXCNT <br />Llmlt 1 <br />Limit 2 <br />Limit 3 <br />Deductible Amount <br />Deductible Type <br />Premium <br />$150.00 <br />Ref # <br />Description <br />Coverage Code <br />Form No. Edition Date <br />State surcharge 3 <br />STSR3 <br />Limit 1 <br />Limit 2 <br />i—t3 <br />Deductible Amount <br />Deductible Type <br />Premium <br />j-Ej;. <br />$2.00 <br />Ref # <br />Description <br />coverage Code <br />Form No. <br />Edit[on Data <br />State surcharge 2 <br />STSR2 <br />Umit1 <br />Limit 2 <br />Limit 3 <br />Deductible Amount <br />Deductible Type <br />Premium <br />$4.00 <br />Ref # <br />Description <br />Coverage Code <br />Form No. Edition Date <br />State surcharge <br />1 <br />STSR1 <br />Limit 1 <br />Llm[t 2 <br />t imit 3 <br />Deductible Amount <br />Deductible Type <br />Premium <br />$23.00 <br />OFADTLCV <br />Copyright 2001, AMS Services, Inc, <br />