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Miscellaneous Attachment: M463694 Certificate ID: 15603400 <br />POLICY NUMBER: TC2J-CAP-131J3858 <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 />NAME: ANY PERSON OR ORGANIZATION FOR WHOM YOU HAVE AGREED IN A WRITTEN <br />CONTRACT THAT NOTICE OF CANCELLATION, OF THIS POLICY WILL BE GIVEN, BUT <br />ONLY IF: <br />1. YOU SEE TO IT THAT WE RECEIVE A WRITTEN REQUEST TO PROVIDE SUCH NOTICE, <br />INCLUDING THE NAME AND ADDRESS OF SUCH PERSON OR ORGANIZATION, AFTER <br />THE FIRST NAMED INSURED RECEIVES NOTICE FROM US OF THE CANCELLATION OR <br />OF THIS POLICY; AND <br />2. WE RECEIVE SUCH WRITTEN REQUEST AT LEAST 14 DAYS BEFORE THE BEGINNING OF <br />THE APPLICABLE NUMBER OF DAYS SHOWN IN THIS ENDORSEMENT. <br />ADDRESS: THE ADDRESS FOR THAT PERSON OR ORGANIZATION INCLUDED IN SUCH WRITTEN <br />REQUEST FROM YOU TO US. <br />PROVISIONS: <br />If we cancel this policy for any statutorilly permitted reason other than nonpayment of premium, and a <br />number of days is shown for cancellation in the schedule above, we will mail notice of cancellation to the <br />person or organization shown in the schedule above. We will mail such notice to the address shown in the <br />schedule above at least the number of days shown for cancellation in the schedule above before the <br />effective date of cancellation. <br />IL T4 05 03 11 <br />Risk Mougenmt Division <br />REVIEWED& AP,PIRovim BY: <br />of\L�1.111Y'-L' f AILi�lM1 M1. Vk(NWFC <br />®' Rlsk Management Analyst <br />