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Policy Number <br />(20)7361-57-65 <br />COMMON POLICY CHANGE ENDORSEMENT <br />Endorsement No. 001 <br />Named Insured PARTNERS IN CONTROL INC Effective Date: 06-15-2020 <br />12:01 A.M., Standard Time <br />Agent Name ECBM LP Agent NO. 50215-999 <br />This endorsement will not be used to decrease coverages, increase rates or deductibles or alter any terms or <br />conditions of coverage unless at the sole request of the insured. <br />COVERAGE PART INFORMATION —Coverage parts affected by this change as indicated by x❑ below. <br />Commercial Property <br />Commercial General Liability <br />Commercial Crime <br />Commercial Inland Marine <br />COMMERCIAL AUTOMOBILE $ 72.00 <br />The following <br />item(s): <br />Insured's Name Insured's Mailing Address <br />Policy Number Company <br />Effective/Expiration Date Insured's Legal Status/Business of Insured <br />❑ <br />Payment Plan Premium Determination <br />Additional Interested Parties Coverage Forms and Endorsements <br />Limits/Exposures Deductibles <br />Covered Property/Located Description Classification/Class Codes <br />Rates Underlying Exposure <br />is (are) changed to read {See Additional Page(s) } <br />SEE NEXT PAGE <br />The above amendments result in a change in the premium as follows: <br />This prernium does not include taxes and surcharges. <br />No Changes <br />❑ To be Adjusted at Audit <br />I Additional $ 72.00 <br />1 Return <br />Tax and Surcharge Changes <br />Additional Return <br />AUTHORIZE <br />16-02.0212(01197) <br />Management DMean f <br />I?Fmexm & APPROVm 9Y: <br />NIMIM-0 Risk Management Analyst - <br />