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<br />SENT BY,:' VAN DUZER INSURANCE; <br /> <br />31 O-:?_~~919; <br /> <br /> <br />MAR.10-Q4 5:28PM; <br /> <br />PAGE 2 <br /> <br />"."if ~j~",~f;"""'~ ' <br /> <br />- . ~ <br /> <br />l <br /> <br />THIS ENDORSEMENT CHANGES THE POUCY. PLEASE READ IT CAREFULLY. <br /> <br />POLICY CHANGE <br /> <br />This ...-......1 changee the p)1cy efIecIIve 011 !he Inœptian Om of .... policy un"" an_. - ill '"icat8d below: <br /> <br />PalII:rN_b8r: 72 IlIA t.G5574 <br /> <br />sc <br /> <br />COpy <br /> <br />'" <br />'" <br />0 <br />.. <br />... <br /> <br />NlIn8d IMured and "'HIIIG Add-= <br /> <br />BRIAN DALY DBA I HYGIBRB <br />'l'BCHIIIOLOG:tES :tIl'1'BRJlAT:tOlll.U., :tNC. <br />3625 DBL AMO BLVD #180 <br />'l'OlIRAKCB CA 90503 <br /> <br />., <br />co <br />.. <br />... <br />.. <br />.. <br />on <br />S <br />N <br />.. <br />... <br />... <br />... <br />.. <br />': <br /> <br />Policy C...,. Eft'8cItv8 D8Ie: 0" 15/ 0 3 <br /> <br />Eft'8cItv8 lID. Ie the ..- ee III8IIId in the <br />Dec18r11ÏD1111 P8ge Dfthe Pallcy. <br /> <br />Pallcy C18n.,. Number: 006 <br /> <br />- <br /> <br />ApnI Name: <br />Code: <br /> <br />D:tCIC VA!! wan. ABSOCJ:ATES, I!IC <br />2501\79 <br /> <br />;;; POUCY CHANGES: <br />iii 110 PIWIIUH DOE AS <br />.. <br />¡¡¡¡ <br />¡¡ <br />.... <br />!! <br />- <br />.- <br />¡; <br />¡¡¡ <br />¡¡ <br />.. <br />- <br />- <br />- <br />- <br />- <br />iiii <br />- <br />- <br />¡¡;; <br />!!! <br />- <br />¡; <br />¡¡¡¡¡ <br />= pao RATA FACTOR' 1.000 <br />- <br />!!ill THJ:S BIIDOUIIIIII'1' DOES HO'1' CHAHGI: TIlE !OLICY pCEPT AS SHOWII. <br /> <br />01 POLICY CRAHGJ: BFnCTIVB DATI!: <br /> <br />rORM R1IHBBRB OJ' EIIDO1ISIIIIII'1'8 REVISED AT J!JIIDORSEIŒN'I' ISSOEI <br /> <br />:tR12001185 ADDZ'J'IOHAL I1I8UUD - PBRSO1I-oRGUIZA'l'IOII <br /> <br />;' I' Ii' ". <br /> <br />~~ 2/:' <br /> <br /> <br />I, <br />/; <br /> <br />Form 881211 0I12T Pñnœd ÎII U,SA. <br />""""" Dele: U / U / 0 3 <br /> <br />Pqe 001 <br /> <br />Pellc)'EJlplrlllon o.te: 09/15/04 <br /> <br />uw COI'Y <br />