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POLICY NUMBER: 810-7N676545-20-43-G <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />DESIGNATED ENTITY - NOTICE OF <br />CANCELLATION PROVIDED BY US <br />This endorsement modifies insurance provided under the following: <br />ALL COVERAGE PARTS INCLUDED IN THIS POLICY <br />SCHEDULE <br />CANCELLATION: Number of Days Notice of Cancellation: 30 <br />PERSON OR <br />ORGANIZATION: ANY PERSON OR ORGANIZATION TO WHOM YOU <br />HAVE AGREED IN A WRITTEN CONTRACT THAT <br />NOTICE OF CANCELLATION OF THIS POLICY <br />WILL BE GIVEN, BUT ONLY IF: <br />1. YOU SEND US A WRITTEN REQUEST TO <br />PROVIDE SUCH NOTICE, INCLUDING THE <br />NAME AND ADDRESS OF SUCH PERSON OR <br />ORGANIZATION, AFTER THE FIRST NAMED <br />INSURED RECEIVES NOTICE FROM US OF <br />THE CANCELLATION OF THIS POLICY; AND <br />2. WE RECEIVE SUCH WRITTEN REQUEST AT <br />LEAST 14 DAYS BEFORE THE BEGINNING OF <br />THE APPLICABLE NUMBER OF DAYS SHOWN <br />IN THIS SCHEDULE. <br />ADDRESS: <br />THE ADDRESS FOR THAT PERSON OR ORGANIZ- <br />ATION INCLUDED IN SUCH WRITTEN REQUEST <br />FROM YOU TO US. <br />PROVISIONS: <br />If we cancel this policy for any statutorily permitted <br />reason other than nonpayment of premium, and a <br />number of days is shown for cancellation in the <br />schedule above, we will mail notice of cancellation to <br />the person or organization shown in the schedule <br />IL T4 05 03 11 ©2011 The Travelers Indemnity Company. All rights reserved. <br />above. We will mail such notice to the address shown <br />in the schedule above at least the number of days <br />shown for cancellation in the schedule above before <br />the effective date of cancellati <br />R16 MnwgemailDtvielnn <br />� { [REVE &(APPROVED Bre. <br />=cYLu�ILLr Mt1GN.[ ram. VaC�tRC <br />® Risk Management Analyst <br />