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ADDITIONAL COVERAGES <br />Ref # <br />Description <br />Business Auto <br />Coverage Code <br />Form No. <br />Edition Date <br />Limit 1 <br />Limit 2 <br />Limit 3 <br />Deductible Amount <br />Deductible Type <br />Premium <br />Ref # <br />Description <br />Increased employer's liability <br />Coverage Code <br />INEL <br />Form No. <br />Edition Date <br />Limit 1 <br />Limit 2 <br />Limit 3 <br />Deductible Amount <br />Deductible Type <br />Premium <br />$2.00 <br />Ref # <br />Description <br />GAIIP <br />Coverage Code <br />GAIIP <br />Form No. <br />Edition Date <br />Limit 1 <br />Limit 2 <br />Limit 3 <br />Deductible Amount <br />Deductible Type <br />Premium <br />Ref # <br />Description <br />Increased employer's liability <br />Coverage Code <br />INEL <br />Form No. <br />Edition Date <br />Limit 1 <br />Limit 2 <br />Limit 3 <br />Deductible Amount <br />Deductible Type <br />Premium <br />$5.00 <br />Ref # <br />Description <br />Add'I for policy minimum premium <br />Coverage Code <br />APMP <br />Form No. <br />Edition Date <br />Limit 1 <br />Limit 2 <br />Limit 3 <br />Deductible Amount <br />Deductible Type <br />Premium <br />$63.00 <br />Ref # <br />Description <br />Increased employer's liability <br />Coverage Code <br />INEL <br />Form No. <br />Edition Date <br />Limit 1 <br />Limit 2 <br />Limits <br />Deductible Amount <br />Deductible Type <br />Premium <br />$5.00 <br />Ref # <br />Description <br />Expense constant <br />Coverage Code <br />EXCNT <br />Form No. <br />Edition Date <br />Limit 1 <br />Limit 2 <br />Limit 3 <br />Deductible Amount <br />Deductible Type <br />Premium <br />$200.00 <br />Ref # <br />Description <br />Coverage Code <br />Form No. <br />Edition Date <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. <br />Edition Date <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. <br />Edition Date <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. <br />Edition Date <br />Limit 1 <br />Limit 2 <br />Limit 3 <br />Deductible Amount <br />Deductible Type <br />Premium <br />OFADTLCV Copyright 2001, AMS Services, Inc. <br />M <br />