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POLICY NUMBER: 46 SBM UM3801 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ENDORSEMENT #003 <br />EFFECTIVE DATE 10/23/2015 <br />ENDORSEMENT 003 EFFECTIVE DATE IS AMENDED TO 08/28/2015 <br />Form 111 12 00 11 85 T SEQ. NO. 004 Printed in U.S.A. Page 001 <br />ProcessDate:! 01107116 Expiration Date: 04/16/16 <br />-12 <br />R'DADAIED B'e� HEF°EEXA (F,C;13)u <br />.. . ........ <br />