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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />POLICY CHANGES <br />Policy Change <br />Number 04 <br />POLICY NUMBER <br />POLICY CHANGES <br />COMPANY <br />EFFECTIVE <br />NXTDVKRHP4-00-GL <br />10/04/2022 <br />State National Insurance- Company, Inc. <br />NAMED INSURED <br />AUTHORIZED REPRESENTATIVE <br />Oscar Ramirez <br />Mantra <br />1520 E Wellington Ave <br />Eric Harnden <br />Santa Ana, CA 92701 <br />COVERAGE PARTS AFFECTED <br />Commercial General Liability Coverage Part <br />CHANGES <br />SEE ATTACHED SCHEDULE <br />Return Total $0.00 <br />4P-� <br />Authorized Representative Signature <br />BoaPink Mmogenad Mid= <br />IL 12 01 1185 Copyright, Insurance Services Office, Inc., 1983 eny REVIEI#rED&APPROVED BY: <br />Copyright, ISO Commercial Risk Services, Inc., 1983 °i i1 <br />Risk Management Analyst <br />