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Policy No. <br />A SCOTTSDALE INSURANCE COMPANY' <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />EXTENSION OF SUPPLEMENTAL DECLARATIONS <br />CPS2561230 <br />Effective Date: 11 / 2 6 / 2 016 <br />12:01 A.M., Standard Time <br />Named Insured HIBA SHUBLAK DBA: ACTIVE LEARNING Agent No, 04068 <br />Prem. No. Bldg, No. <br />1 1 <br />Class Code <br />47475 <br />Exposure <br />80, 000 <br />Basis <br />GROSS SALES <br />Class Description: <br />SCHOOLS - PRIVATE - ELEMENTARY, KINDERGARTEN OR <br />JUNIOR HIGH (OTHER -THAN -NOT -FOR -PROFIT) <br />(PRODUCTS -COMPLETED OPERATIONS ARE SUBJECT TO THE <br />GENERAL AGGREGATE LIMIT) <br />Premises/ Operations <br />Rate <br />Premium <br />24 <br />1,920 <br />Products/ Comp Operations <br />Rate <br />Premium <br />INCLUDED <br />INCLUDED <br />Prem, No. Bldg, No. <br />Class Code <br />Exposure <br />Basis <br />Class Description: <br />Premises/ Operations <br />Rate <br />Premium <br />Products/Comp Operations <br />Rate <br />Premium <br />Prem, No. Bldg. No. <br />Class Code <br />Exposure <br />Basis <br />Class Description: <br />d Q`• <br />Premises/ Operations <br />Rate <br />Premium <br />Products/ Comp Operations <br />Rate <br />Premium <br />Prem. No. Bldg. No. <br />Class Code <br />Exposure <br />Basis <br />Class Description:�\�®� �iP <br />Premises/ Operations <br />Rate <br />Premium <br />Products/ Comp Operations <br />Rate <br />Premium <br />CLS-SP-1 L(10-93) INSURED clsspllf . fap <br />