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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 />Ln Policy Number: 30 SBMT08465 DV COPY <br />0 <br />0 <br />Named Insured and Mailing Address; JAMES GANIERE <br />DBA- OH RIO PRODUCTION <br />C". 4900 CALIFORNIAN AVE, TOWER B-210 <br />BAX=SFIE= CA 93309 <br />NPolicy Change Effective Date: 05/04/11 Effective hour is the same as stated in the <br />o Declarations Page of the Policy. <br />o Policy Change Number: 002 <br />0 <br />.-1 <br />o Agent Name. MAURY DONNELLY & PARR INC/PHS <br />Code: 721336 <br />POLICY CHANGES: <br />s� HARTFORD CASUALTY INSURANCE COMPANY <br />1 ANY CHANGES IN YOUR PREMIUM WILL BE REFLECTED IN YOUR NEXT BILLING <br />1 STATEMENT. <br />THIS IS NOT A BILL. <br />NO PREMIUM DUE AS OF POLICY CHANGE EFFECTIVE DATE <br />s <br />FORM NUMBERS OF ENDORSFMEMYT'S REVISED AT ENDORSEME= ISSUE: <br />®_ MH12001185 ADDTTTONAL INSURED - PERSON -ORGANIZATION <br />t= <br />EiiB <br />a <br />PRO RATA FACTOR: 1_000 <br />opgo <br />THIS ENDORSEMENT DOES NOT CHANGE THE POLICY EXCEPT AS SHOWN. <br />Form SS 12 11 04 OS T Page 001 <br />Process Date: 03/23/11 Policy Effective Date: 05/04/11 <br />Policy Expiration Date: 05/04/12 <br />PRODUCER COPY <br />