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POLICY CHANGE DOCUMENT <br />POLICY NO.: PHPK282204 <br />Philadelphia Indemnity Insurance Company 19939 DRIVER ALLIANT INSURANCE SERVICES, <br />■�` i �11.I��i I ��Irlr�� r <br />NAMED INSURED Achievement Institute of Scientific Stud <br />MAILING ADDRESS 1621 Bullard Ln <br />Santa Ana, CA 92705-8401 <br />POLICY PERIOD: FROM 12/26/2007 TO 12/26/2008 at <br />12:01 A.M. Standard Time at your mailing address shown above. <br />CHANGE EFFECTIVE 12/26/2007 CHANGE # 1 <br />DESCRIPTION - <br />In consideration of the premium reflected, the policy is amended as indicated below: <br />Added Manuscript Endorsement - PI -NP -003 <br />Path ID 2776583 <br />Total Annual <br />Additional/Return Premium $ <br />COUNTERSIGNED <br />Total Prorate <br />0.00 Additional/Return Premium $ 0.00 <br />NO CHANGE NO CHANGE <br />BY <br />(Date) (Authorized Representative) <br />Horne Office Copy Page 1 of t <br />