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Policy Number: 42SBWB17030 <br /> 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 certificate holder(s) with mailing addresses on file <br /> than for non-payment of premium, notice of such with the agent of record or the Company. <br /> cancellation will be provided at least thirty (30) days Any notification rights provided by this endorsement <br /> in advance of the cancellation effective date to the apply only to active certificate holder(s) who were issued <br /> certificate holder(s) with mailing addresses on file a certificate of insurance applicable to this policy's term. <br /> with the agent of record or the Company. <br /> If notice is mailed, proof of mailing to the last known <br /> B. If this policy is cancelled by the company for non- mailing address of the certificate holder(s) on file with <br /> payment of premium, or by the insured, notice of the agent of record or the Company will be sufficient <br /> such cancellation will be provided within ten (10) proof of notice. <br /> days of the cancellation effective date to the <br /> Form SS 12 24 06 11 Page 1 of 1 <br /> © 2011, The Hartford <br />