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<br />" <br /> <br />- <br />- <br />!! <br />- <br />- <br />ïIIii <br />¡¡¡¡ <br />- <br />- <br />- <br />== <br />1 <br />¡¡¡ <br />iiiï <br />- <br />- <br />- <br />..... <br />- <br />- <br />.. <br />¡¡¡ <br />- <br />- <br />- <br />!!!!!!! <br /> <br />DEC-23-2001 15:25 <br /> <br />13129225358 <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> <br />POLICY CHANGE <br /> <br />P.EJ2/05 <br /> <br />. <br /> <br />... <br /><> <br />... <br /><> <br />() <br /> <br />Polley Numb8r: 83 SBW PQ3 5 36 <br /> <br />DD <br /> <br />C:OPY <br /> <br />ThiS 8nc1om11nenl Changes u.. policy effectiVo on ths Inception Dele of!he policy l1li- another - is indicated below: <br /> <br />!'lamed In8urecI and M8111ng Add-: <br /> <br />LORRIE BOWRICX. DVM <br /> <br />on <br />" <br />... <br />" <br />'" <br />,~ <br />on <br />... <br />~ <br />... <br />.. <br />0 <br /><> <br />'" <br />.... <br />c <br />. <br /> <br />133 0 N GLASSBLI. BUITB M <br />ORAIIGE C:A 9~&69 <br /> <br />PoJlcyChanu-E---Dat8: 12/15/04 <br /> <br />El'l'8cl:1v8 hour II 1M 8a.... - 8Ial8d In the <br />Dee,,"""'" Pate of 1M PoIIc~. <br /> <br />Policy Ch.,.. Numb8r: 001 <br /> <br />Agenl N.....: <br />Code: <br /> <br />I<UB INTERNATIONAL OF ILI.INOIS LTD <br />55072& <br /> <br />- <br />.... <br />- <br />- <br />- <br />- <br />- <br />- <br />- <br />- <br />- <br /> <br />POLICY CHANGES: <br />NO PRE"'IUM D1J1I AS OF POLICY CHAIIGE EFFEc:TIVS DATE <br /> <br />BUSINESS WABILITY OPTIONAL COVlRAGSS ARE RJ¡VISRD <br /> <br />ADDITIONAl. INSURED(S) lIRE ADDED <br />TIIII FOLLOWING ARB ADDITIONAL INSURBD FOil BUSINESS LIAIIILITY COVBRAGB IN <br />THIS POLICY. . <br />I.OCATION 001 B11ILDIIIG 001 <br />PERSON/ORGANIZATION: SE.!: FORM IH 12 DO <br /> <br />FORM NlJMl!BRS OF ENDORSEMENTS ADDED AT ENDORSBMBIIT ISSUE: <br /> <br />1812001105 ADDITIONAL INSUIISD . PERSON-ORGANIZATION <br /> <br />PRO RATA FACTOR; 1.000 <br /> <br />THIS ENDORSEMENT DOSS NOT t.'HAIIOõI THB POLICY BXCBP'I' AS SHOWl!. <br /> <br />Form sa 12 11 UnT Printed In U.SA <br />Proc_D8I8: 1~/17/04 <br /> <br />PII 8 001 <br /> <br />Policy II!IIpII'8IIonDel8< 06/24/05 <br /> <br />uw COPY <br /> <br />~f/r <br />