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I?320I}Ofi069fi00a69 <br />Policy Number TB2-681-004145-716 <br />Issued by LIBERTY MUTUAL FIRE INSURANCE COMPANY <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />NOTICE OF CANCELLATION TO THIRD PARTIES <br />This endorsement modifies insurance provided under the following: <br />BUSIN56S AUTO COVERAGE PART <br />MOTOR CARRIER COVERAGE PART <br />GARAGE COVERAGE PART <br />TRUCKERS COVERAGE PART <br />EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART <br />SELF-INSURED TRUCKER EXCESS LIABILITY COVERAGE PART <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART <br />LIQUOR LIABILITY COVERAGE PART <br />COMMERCIAL LIABILITY- UMBRELLA COVERAGE FORM <br />A. If we Cancel this policy for any reason other than nonpayment of premium, we will notify the persons or <br />organizations shown In the. Schedule above. We will serxi notice to the email or mailing address listed above <br />at least ACS days, or the number of days listed above, if any, before the cancellation becomes effective. In no <br />event does the notice to the third patty exceed the notice to the first named insured. <br />B. This advanoa notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to <br />provide such advance notification will not extend the policy cancellation date nor negate cancellation of the <br />policy. <br />All other terms and Conditions of this policy remain unchanged. <br />LIM 99 01 05 it 0 2011 Liberty Mutual Group of Companies. All rights reserved. Page A of 1 <br />Includes ocpyrlghtad material of Insurance Services Office, Ina., with <br />its permission. <br />Schedule <br />Name of (lthar Parsan(s)1 <br />Email Address or matting address; <br />Number Days Notice: <br />_ <br />Per. schedule on file <br />schOrt�anlzationts}: <br />e_a e err' z a <br />W th the company <br />0 <br />A. If we Cancel this policy for any reason other than nonpayment of premium, we will notify the persons or <br />organizations shown In the. Schedule above. We will serxi notice to the email or mailing address listed above <br />at least ACS days, or the number of days listed above, if any, before the cancellation becomes effective. In no <br />event does the notice to the third patty exceed the notice to the first named insured. <br />B. This advanoa notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to <br />provide such advance notification will not extend the policy cancellation date nor negate cancellation of the <br />policy. <br />All other terms and Conditions of this policy remain unchanged. <br />LIM 99 01 05 it 0 2011 Liberty Mutual Group of Companies. All rights reserved. Page A of 1 <br />Includes ocpyrlghtad material of Insurance Services Office, Ina., with <br />its permission. <br />