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Policy Number:AS2-661-067353-02 <br />Issued by:Liberty MutualFire Insurance Co. <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />NOTICE OF CANCELLATION TO THIRD PARTIES <br />This endorsement modifies insurance provided under the following: <br />BUSINESS AUTO COVERAGE PART <br />MOTOR CARRIER COVERAGE PART <br />GARAGE COVERAGE PART <br />TRUCKERS COVERAGE PART <br />EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART <br />SELF-INSURED TRUCKER EXCESS LIABILITY COVERAGE PART <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART <br />LIQUOR LIABILITY COVERAGE PART <br />COMMERCIAL LIABILITY – UMBRELLA COVERAGE FORM <br />Schedule <br />Name of Other Person(s) /Email Address: <br />Organization(s): <br />Per schedule on file with broker <br />A.Ifwe cancel this policy for any reason other than nonpayment of premium, we will notify the persons or <br />organizations shown in the Schedule aboveby email as soon as practical after notifying the first Named Insured. <br />B.This advance email notification of a pending cancellation of coverage is intended as a courtesy only. Our failure <br />to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the <br />policy. <br />All other terms and conditions of this policy remain unchanged. <br />CzDzouijbNpsbbu6;33qn-Efd21-3135 <br />LIM99 02 0811©2011 Liberty Mutual Group of Companies. All rights reserved. Page 1of 1 <br />Includes copyrighted material of Insurance Services Office, Inc., with <br />its permission. <br /> <br />