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DocuSign Envelope 10: FC7E9346-8A22-4923-BD05-AA3CA0439841 <br />Attachment Code: D578870 Certificate ID: 16765248 <br />Notification to Others of Cancellation <br />Eff. Date of <br />Exp. Date of <br />Add'] <br />Return <br />Policy No. <br />ff. Date of End. <br />Producer <br />Pol. <br />Pol. <br />Prem. <br />Prem. <br />BAP01463 <br />8/28/2022 <br />8/28/2023 <br />8/28/2022 <br />S 1 <br />S <br />29 <br />NCL <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />This endorsement modifies insurance provided under the: <br />Commercial Automobile Coverage Part <br />A. If we cancel this Coverage Part by written notice to the first Named Insured for any reason other <br />than nonpayment of premium, we will mail or deliver a copy of such written notice of cancellation: <br />1. To the name and address corresponding to each person or organization shown in the <br />Schedule below; and <br />2. At least 10 days prior to the effective date of the cancellation, as advised in our notice to <br />the first Named Insured, or the longer number of days notice if indicated in the Schedule below. <br />B. If we cancel this Coverage Part by written notice to the first Named Insured for nonpayment of <br />premium, we will mail or deliver a copy of such written notice of cancellation to the name and <br />address corresponding to each person or organization shown in the Schedule below at least 10 <br />days prior to the effective date of such cancellation. <br />C. If notice as described in Paragraphs A. or B. of this endorsement is mailed, proof of mailing will <br />be sufficient proof of such notice. <br />SCHEDULE <br />Number of <br />Name and Address of Other Person(s) 1 Organization[s]: <br />Days <br />Notice: <br />Per Attached Certificate <br />30 <br />All other terms and conditions of this policy remain unchanged. <br />U-CA-812-A CW (05110) <br />