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J0%,' SCOTTSDALE INSURANCE COMPANY" <br />ENDORSEMENT <br />NO. <br />ATTACHED TO AND <br />ENDORSEMENT EFFECTIVE DATE <br />FORMING A PART OF <br />Iy 2;D7 A.M. STANDARD TIME) <br />NAMED INSURED <br />AGENTNO, <br />POLICY NUMBER <br />CPS2561230 <br />11/26/2016 <br />HIBA SHUSLAK DSA: ACTIVE LEARNING <br />04068 <br />THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. <br />OPTIONAL PROVISIONS ENDORSEMENT <br />The following special provisions (indicated by an "x") apply to this policy: <br />SCHEDULE <br />M Bodily Injury, Property Damage, Personal Injury and Advertising Injury Liability Deductible <br />Endorsement <br />Coverage <br />Amount and Basis of Deductible <br />Bodily Injury Liability <br />$ 500 per claimant <br />Property Damage Liability <br />$ 500 per claimant <br />Personal and Advertising Injury Liability <br />$ 500 per claimant <br />M Service of Suit Clause <br />Service of Process will be accepted by: COMMISSIONER_ OF INSURANCE_________________ <br />45 FREMONT_STREET _239D_FL0ORy_SPSLFRANCISCO_CA94105_--- _----- _,and <br />Service of Process will be mailed to: C10 _UNITED STATES CORPORATION_ COMPANY____________—_ <br />2210__OATEWAY OAKS DRIVE, --SUITE 150_MSACJ2AM,EMTOsATE},3__E505________________ <br />M Minimum and Advance Premium Endorsement <br />Minimum Premium <br />IN Minimum Earned Cancellation Premium <br />Minimum Earned Cancellation Premium <br />of the advance premium. <br />ed <br />Includes copyrighted material of ISO Properties, Inc., with its permission. ��^^�,ei��� <br />Copyright, 150 Properties, Inc., 2007 % <br />1.J.O G-D <br />e !AA <br />UTS-128s (8-15) Page 1 of <br />INSURED �m:9128s-o.fap <br />