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POLICY CHANGE (Continued) <br />Policy Number: 30 SBM T08465 <br />Policy Change Number: 001 <br />FORM NUMBERS OF ENDORSEMENTS ADDED AT ENDORSEMENT ISSUE_ <br />IR12001185 ADDITIONAL INSURED - PERSON -ORGANIZATION <br />IH12001185 NOTICE OF CANCELLATION OR NON -RENEWAL TO <br />DESIGNATED PERSON(S) OR ORGANIZATION(S) OTHER <br />THAN THE NAMED INSURED- SS12200810 <br />Form 58 12 11 04 05 T Page 002 <br />Process Date: 02/25/31 <br />