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<br />.~ <br /> <br />~ <br /> <br />= <br />~ <br /> <br />- <br />= <br />- <br /> <br />---'-',-? '::1 20' <br /> <br />From: <br /> <br />To: 17145714209 <br /> <br />Page:2-3 <br /> <br />. <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFUllY. <br /> <br />POLICY CHANGE <br /> <br />~", ~'1dC<'Sement changes the policy effective on the Inception Oate of the policy unless enolher dete s indicated <br />below: <br /> <br />~ "olicy Number: 12 SBA A09670 DX <br /> <br />COpy <br /> <br />" <br />c <br /> <br />. ,.-.". :nsured and Mailing Add...ss: DIAGNOSTIC VETERINARY UlBORA-rOR Ies <br />HlC <br />1401 E SOUTH ST <br />LONG BEliCH <br /> <br />CA 90805 <br /> <br />~ <br /> <br />"'oiiey Change Effective Date: <br /> <br />oef';;.S/07 <br /> <br />Effective hour Is the same as stated In the <br />Declarations Page of the Policy. <br /> <br />~ <br /> <br />", <br />'" <br />o <br />- <br />o <br />. <br /> <br />Policy Change Number: 003 <br /> <br />Agent Name; GRAY-STONE & COMPANY/PHS <br />':Cdg; 25395< <br /> <br />-,:"-,~i <br />== <br /> <br />"Olley CHANGES: <br />HARTFORD CASUALTY INSURANCE COHPIINY <br /> <br />- <br /> <br />AN'{ CIlANG:::S III '{OUll PREMIUM WILL all REFLECTED IN YOUR NEXT BILLING <br />S'1'A.T~MIlN'l'. <br /> <br />THIS IS NOT A BILL. <br /> <br />~o PREMIUM DUE AS OF pOLICY CHANGE E~FECnVI!: DATE <br /> <br />~ <br /> <br />K;'1.1S:,RS 0, :?iNDORSEMENTS REVISEO AT ENDORSEMENT ISSUE: <br /> <br />I~:l:, :Cl:Sl; ADDITIONAL INSURED - PERSON.ORG/l.NI2ATION <br /> <br />??:O AATA FACTOR, 1. 000 <br /> <br />'""IS ENDORSEMENT DOES NOT CllJINCll THE POLICY EXCEPT AS SHOWN. <br /> <br />Form 55 1211 0405 T <br />Process Date: 10/18/07 <br /> <br />Page 001 <br /> <br />Policy Effective Dale: OS/2 ;f07 <br />Policy expiration Date; oe/::6/oe <br /> <br />Uli COpy <br /> <br />, <br />