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POLICY CHANGE <br />This endorsement changes the policy effective on the Inception Date of the policy unless another date is indicated <br />below: <br />Policy Number: 72 SBA NU6283 SC COPY <br />co <br />�r <br />Named Insured and Mailing Address; LABELLE-MARVIN INC <br />0 2700 S. GRAND AVE <br />SANTA ANA CA 92705 <br />0 <br />N <br />Policy Change Effective Date: 08/11/10 Effective hour is the same as stated in the <br />N Declarations Page of the Policy. <br />r, <br />o Policy Change Number: 004 <br />0 <br />Agent Name: CM MEIERS COMPANY INC <br />Code: 251597 <br />POLICY CHANGES: <br />HARTFORD CASUALTY INSURANCE COMPANY <br />ANY CHANGES IN YOUR PREMIUM WILL BE REFLECTED IN YOUR NEXT BILLING <br />STATEMENT. <br />THIS IS NOT A BILL. <br />ADDITIONAL PREMIUM DUE AT POLICY CHANGE EFFECTIVE DATE: $21,00 <br />RATES AND PREMIUMS ARE CHANGED. <br />FORM NUMBERS OF ENDORSEMENTS REVISED AT ENDORSEMENT ISSUE: <br />IH12001185 WAIVER OF SUBROGATION <br />IH12001185 ADDITIONAL INSURED - PERSON -ORGANIZATION <br />PRO RATA FACTOR: 0.847 <br />CJ <br />E <br />