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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />POLICY CHANGES <br />Policy Change <br />NumhPr r15 <br />POLICY NUMBER POLICY CHANGES COMPANY <br />AXGL03100381-11 EFFECTIVE AXIS Insurance Company <br /> 04/22/1 1 <br />NAMED INSURED AUTHORIZED REPRESENTATIVE <br />The National Archery Association of the US American Specialty Insurance 8 Risk <br /> Services, Inc. dba A. S.I. R.S.I. Insurance <br /> Agency, American Specialty Insurance 8 <br /> Risk Services Agency, and A S Insurance & <br /> Risk Services A enc <br />COVERAGE PARTS AFFECTED <br />Commercial General Liabilit <br />CHANGES <br />As of the effective date hereof, it is hereby understood and agreed that the attached Form CG 2026(07/04) <br />ADDITIONAL INSURED -DESIGNATED PERSON OR ORGANIZATION is added to the policy, but only with <br />respect to Parks and Recreation Program at Santiago Park Archery Range from April 22, 2011 through January <br />14, 2012. <br />No additional premium due. <br />All other terms and conditions remain unchanged. <br />Issued b : KS A ril 28, 2011 <br />.? <br />Authorized epresentative Signature <br />IL 12 01 17 85 Copyright, Insurance Services Office, Inc., 1983 Page 1 of 1 l7 <br />Copyright, ISO Commercial Risk Services, Inc., 1983