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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />POLICY CHANGE <br />This endorsement changes the policy effective on the Inception Date of the policy unless another date is indicated <br />below: <br />co Policy Number: 72 SBA IA6077 DX <br />0 <br />M <br />0 <br />Cr <br />0 <br />T <br />E- <br />O <br />F4 <br />H <br />N <br />O <br />0 <br />0 <br />0 <br />COPY <br />Named Insured and Mailing Address; CINDY KREBS CONSULTING, INC. <br />26 CALAIS <br />NEWPORT COAST <br />Policy Change Effective Date: 06/24/09 <br />Policy Change Number: 001 <br />Agent Name: NHC INSURANCE SERVICES, INC/PHS <br />Code: 253751 <br />CA 92657 <br />Effective hour is the same as stated in the <br />Declarations Page of the Policy. <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 />NO PREMIUM DUE AS OF POLICY CHANGE EFFECTIVE DATE <br />RATES AND PREMIUMS ARE CHANGED. <br />BUSINESS LIABILITY OPTIONAL COVERAGES ARE REVISED <br />10 V00 <br />0'�� <br />5g0NINOINN- <br />1.�`'P ti G�t`1 <br />A55�s�ar <br />ADDITIONAL INSURED(S) ARE ADDED <br />THE FOLLOWING ARE ADDITIONAL INSURED FOR BUSINESS LIABILITY COVERAGE IN <br />THIS POLICY. <br />LOCATION 001 BUILDING 001 <br />PERSON/ORGANIZATION: SEE FORM IH 12 00 <br />PRO RATA FACTOR: 0.948 <br />THIS ENDORSEMENT DOES NOT CHANGE THE POLICY EXCEPT AS SHOWN. <br />Form SS 12 11 04 05 T <br />Process Date: 06/24/09 <br />UW COPY <br />Page 001 (CONTINUED ON NEXT PAGE) <br />Policy Effective Date: 06/24/09 <br />Policy Expiration Date: 06/05/10 <br />