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Auto 0/C /nsurance <br />Schedu /e of Forms <br />Po /icy Period APRIL 16, 2012 TO APRIL 16, 2013 <br />Effective Oate SEPTEMBER 18, 2012 <br />Po /icy Number 3587 -79 -16 NBO <br />/nsured ACTNE NETWORK INC <br />Name of Company FEDERAL INSURANCE COMPANY <br />Oate /ssued SEPTEMBER 18, 2012 <br />The following is a schedule of forms issued as of the date shown above: <br />Edition <br />Form Number Oate Form Name <br />80 -02 -0130 <br />5 -00 <br />INTERNATIONAL AUTO LIABILITY DECLARATION <br />80 -02 -2054 <br />5 -00 <br />INTERNATIONAL AUTOMOBILE LIABILITY <br />80 -02 -2496 <br />5 -00 <br />HIRED AND NON -OWNED PHYSICAL DAMAGE <br />80 -02 -2497 <br />5 -00 <br />I-IIRED AND NON -OWNED <br />Effective Oate <br />Oate /ssued <br />04/ 16/ 12 <br />04/26/ 12 <br />04/16/12 <br />04/26/12 <br />04/16/12 <br />04/26/12 <br />04/16/12 <br />04/26/12 <br />Reference Copy last page <br />Form 80 -02 -5799 (EO. 5 -00) Schedule of Forms Paga � <br />