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DMS Facility Services, LLC <br />Policy Term 10/1/2021 - 10/1/2022 <br />Business Auto Policy <br />Policy Number: AS6-691-458727-071 <br />Issued By: :he First L'_berty insurance Corp. <br />THIS ENDORSEINENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />NOTICE OF CANCELLATION TO THIRD PARTIES <br />This endorsement modifies insurance provided unde- the following <br />BUSINESS AUTO COVERAGE PART <br />MOTOR CARRIER COVERAGE PART <br />GARAGE COVERAGE PART <br />TRUCKERS COVERAGE PART <br />EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART <br />SELF -INSURED TRUCKER EXCESS LIABILITY COVERAGE PART <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART <br />LIQUOR LIABILITY COVERAGE PART <br />Schedule <br />Name of Other Person(s)l Email Address or mailing Number <br />Organ ization(s): address: Days <br />_ Notice: <br />,broker will provide list of �— 30 <br />organizations and contacts at least i <br />10 days prior to the advanced <br />notification date <br />j <br />! <br />A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or <br />organizations shown in the Schedule above. We will send notice to the email or mailing address listed <br />above at least 10 days, or the number of days listed above, if any, before the cancellation becomes <br />effective. in no event does the notice to the third party exceed the notice to the first named insured. <br />This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure <br />to provide such advance notf€cation will not extend the policy cancellation date nor negate cancellation of <br />the policy. <br />All other terms and conditions of this policy remain unchanged. <br />LIM 99 01 05 11 Gc' 2011, Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1 <br />Includes copyrighted material of Insurance Services Office. Inc. <br />with its permission. <br />� Beni nrvisiort <br />+wR"EwED 6 APPROVED BY: <br />ctze P& , <br />Risle Management Cierir lAide <br />