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WC 4641353 (AIDS) <br />990634 <br />WC <br />NOTIFICATION TO OTHERS OF CANCELLATION, 0ONRENEW8LOR REDUCTION OF <br />INSURANCE ENDORSEMENT <br />This endorsement is used to add the following Vv Part Six nf the policy. <br />PART SIX <br />CONDITIONS <br />A. if we cancel m non-renew this policy by written notice toyoe for any reason other than nonpayment <br />of premium, we will mallor deliver a copy of such written notice of cancellation or non-renewal to <br />the name and address corresponding to each person or organization shown in the Schedule below. <br />Notification to such person or organization will be provided at least 10 days prior to the effective date <br />ofthecancoQatiwnurnoo'renewal,asaddSed|nourn0ticoOoVou/orthe\0ngernumberufd8ys <br />notice )f indicated iu the Schedule below. <br />13� Ifvve cancel this policy bv written notice k) you for nonpayment wf premium, we will mail or deliver <br />copy of such wdttmnnotice cf cancellation to the name and address corresponding to each person or <br />organization shown |m the Schedule below at least 10 days prior tn the effective date ufsuch <br />cancellation, <br />C. If coverage afforded bvthis policy is reduced or restricted, except for any reduction ofLimits of <br />Liability due to payment of claims, we will mail! or deliver notice of such reduction or restriction to the <br />name and address corresponding to each person or organization shown In the Schedule below. <br />Notification to such person or organization will be provided at least 10 days prior to the effective date <br />of the reduction n« restriction, or the longer number of days notice if indicated in the Schedule <br />below. <br />D.D! notice as described inParagraphs A^^8,OrK.nf this endorsement is mailed, proof of mailing will <br />be sufficient proof of such notice. <br />SCHEDULE <br />Name and Address of Other Person(s) Organization(s) Nuri of <br />City of Santa Ana <br />Avanue. M-6 <br />Santa Ana CA 92703 <br />A& other terms and conditions cJ this policy remain unchanged, <br />This endorsernant charges the policy to which it is attached and is effective on the date �^sued unless otherwise stated, <br />(The Information below is required only when this endorsement {sissued subsequent tv preparation «fd`Ispolicy) <br />F.nclo,wmmnt6M*¢ivnnzoo Policy Number sodnnmmont No, pom, <br />Insurance Company <br />Attachment Code: D4w390] <br />Certificaft D): 11363208 <br />