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Allianz ili <br />a. If the revised annual premium determined above is an additional premium, this additional premium may <br />be waived by us for the remainder of the policy term. <br />b. If the revised annual premium determined above is a return premium, we will refund this amount to you. <br />All other terms and conditions of the policy remain unchanged. <br />17858701 15 <br />Copyright© 2015 Allianz Global Risks US Insurance Company. All rights reserved. <br />Includes copyrighted material of Insurance Services Once, Inc., wit its permission. <br />w.k htol�mnit olylalall <br />Remo&APPROVED BY. <br />�' Risk blanngenrent Analyst <br />