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n <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />POLICY CHANGE <br />This endorsement changes the policy effective on the Inception Date of the policy unless another date is indicated <br />below: <br />Policy Number: 72 SEA DZ5095 SC <br />Named Insured and Mailing Address; CARPENTER, ROTHANS & DUMONT LLP <br />SEE FORM SS1235 <br />500 S GRAND AVE STE 1900 <br />LOS ANGELES CA 90071 <br />Policy Change Effective Date: 02/25/20 Effective hour is the same as stated in the <br />Declarations Page of the Policy. <br />Policy Change Number: 003 <br />Agent Name: AJ GALLAGHER & CO INS BRKRS OF CA <br />Code: 255201 <br />POLICY CHANGES: <br />SENTINEL INSURANCE COMPANY. LIMITED <br />ANY CHANGES IN YOUR PREMIUM WILL BE REFLECTED IN YOUR NEXT BILLING <br />STATEMENT.I.F YOU ARE ENROLLED IN REPETITIVE EFT DRAWS FROM YOUR BANK <br />ACCOUNT, CHANGES IN PREMIUM WILL CHANGE FUTURE DRAW AMOUNTS. <br />THIS IS NOT A BILL. <br />NO PREMIUM DUE AS OF POLICY CHANGE EFFECTIVE DATE <br />FORM NUMBERS OF ENDORSEMENTS REVISED AT ENDORSEMENT ISSUE: <br />IH12001185 ADDITIONAL INSURED - PERSON -ORGANIZATION <br />PRO RATA FACTOR: 0.964 <br />THIS ENDORSEMENT DOES NOT CHANGE THE POLICY EXCEPT AS SHOWN. <br />Form SS 12 11 04 05 T Page ool Res <br />Process Date: 03/11/20 Policy Effective I I i 76u <br />Policy Expiration WOW R.k W.,1-1 0m.]Ad. <br />