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POLICY NUMBER: 41 SBA AD7771 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />AMENDMENT OF THE DECLARATIONS - ADDITIONAL <br />PERSONS OR ORGANIZATIONS DESIGNATED AS NAMED <br />INSUREDS <br />The following person(s) or organization(s) are added to the Declarations as Named Insureds: <br />360 CIVIC <br />FEIN: 86-2205980 <br />Form SS 12 35 03 12 SEQ. NO. oc5 Page col <br />Process Date: 06/16/21 <br />© 2012, The Hartford <br />Y.id�Aty genet OiWtla <br />RenEwEo6Avvr+w®Br <br />- 76ue pi -au <br />Expirati <br />Ri51�F/ m9enan Um�al Aitle <br />