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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S) <br />This policy is subject to the following additional Conditions: <br />A. If this policy is cancelled by the Company, other If notice is mailed, proof of mailing to the last known <br />than for non-payment of premium, notice of such mailing address of the certificate holder(s) on file with <br />cancellation will be provided at least thirty (30) days the agent of record or the Company will be sufficient <br />in advance of the cancellation effective date to the proof of notice. <br />certificate holder(s) with mailing addresses on file Any notification rights provided by this endorsement <br />with the agent of record or the Company. apply only to active certificate holder(s) who were issued <br />B. If this policy is cancelled by the company for non- a certificate of insurance applicable to this policy's term. <br />payment of premium, or by the insured, notice of Failure to provide such notice to the certificate holder(s) <br />such cancellation will be provided within ten (10) will not amend or extend the date the cancellation <br />days of the cancellation effective date to the becomes effective, nor will it negate cancellation of the <br />certificate holder(s) with mailing addresses on file policy. Failure to send notice shall impose no liability of <br />with the agent of record or the Company. any kind upon the Company or its agents or <br />representatives. <br />Form SS 12 23 06 11 <br />© 2011, The Hartford <br />Dn <br />E APPRavmnms r <br />F�� P V L 4a <br />Risk Management Analyst <br />