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NOTICE OF CANCEILAT[ON ID THIRD PARTIES <br />A. If we canwfl Vils poliq for any reason othoi than f1WINAYMMIt Of prenlhU, we, VVM notlf° r the persons or <br />organizabons, shown in the Schedule belowVii o will send notice to the email or mail'Ing address listed below at <br />least 10 days, or the number of drays 11sted b0ow, if any, befure w xrtasrailrata sa beramea WeatKw, In no event <br />does Ihe� notic's tr.'sthe third Polty axoGed the nok'e, W tho, rws'l namod <br />S. Thi* advance nortricallon of a pendIng cancetlation of crjveafjo is intended ws a oouitesq mn"ty, Ow failure trn� <br />provfdp suoh advanre notification will not extend the PoVQY canceffation state nor negate cancollation af the <br />pollcv. <br />9; IMM17 <br />Name of Other Person(u) f Email Address or mailing address: Number Days Notice; <br />�lrrttrat�uta tarn a,; <br />Citv of Sant a,Anq, its officers, 30 <br />employees, ;;gents 9nd reprvsentative <br />All other term;-, and condRion., or �Ms policy remain unchanged, <br />P=100 bV Ubcm ty Wsuranra Carfwrnbun P1 314 <br />FdraltachMOMIOPQ11CYNO, WA7]581)004145775 Prernium <br />IS141w'd to Min. QVI adliot carporalid q <br />Wit go 18 061't 2011, Ubert e Mutual Group, All Mgh Is Reserved. Page I of I <br />Ed. 06101r2011 <br />REVK-.-.'VVED BY: EUNICE w1RIEDIA (P(.; �'()F <br />