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Philadelphia indemnity Insurance Company <br />Fortrt Sciledute — Policy <br />Policy Number. PHPK4�iSti57 <br />Farms and Endorsements applying to this Coverage Part and made a part of this <br />policy at lime. of issue: <br />POrm Edition Description <br />CPp -PIIC Oi 07 Common Policy Dederation <br />LaOatlon Schedule O'1 00 LacafiOn Schedule <br />Fees and Surcharge Schedule 01 00 Fees and Surcharge Schedule <br />r <br />e <br />Page 7 of i <br />T�00 /ZOOS %V3 LS =LT BDOZ /ST /Oi <br />