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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />POLICY CHANGE <br />This endorsement changes the policy effective on the Inception Date of the policy unless another date is indicated <br />below: <br />Policy Number: 72 SBA IT9447 SC <br />Named Insured and Mailing Address; SUDABEH SHOJA DBA <br />ENGINEERING SOLUTIONS SERVICES <br />23232 PERALTA DR, SUITE 112 <br />LAGUNA HILLS CA 92653 <br />Policy Change Effective Date: 12/14/17 Effective hour is the same as stated in the <br />Declarations Page of the Policy. <br />Policy Change Number: 002 <br />Agent Name: PRIME INSURANCE SERVICES INC <br />Code: 186083 <br />POLICY CHANGES: <br />SENTINEL INSURANCE COMPANY, LIMITED <br />ANY CHANGES IN YOUR PREMIUM WILL BE REFLECTED IN YOUR NEXT BILLING <br />STATEMENT.IF YOU ARE ENROLLED IN REPETITIVE EFT DRAWS FROM YOUR BANK <br />ACCOUNT, CHANGES IN PREMIUM WILL CHANGE FUTURE DRAW AMOUNTS. <br />THIS IS NOT A BILL. <br />NO PREMIUM DUE AS OF POLICY CHANGE EFFECTIVE DATE <br />FORM NUMBERS OF ENDORSEMENTS REVISED AT ENDORSEMENT ISSUE: <br />IH12001185 ADDITIONAL INSURED - PERSON -ORGANIZATION <br />IH12001185 ADDITIONAL INSURED - VENDOR <br />PRO RATA FACTOR: 0.680 <br />THIS ENDORSEMENT DOES NOT CHANGE THE POLICY EXCEPT AS SHOWN. <br />Form SS 12 11 04 05 T Page ool <br />Process Date: 12/20/17 Policy Effective Date: 08/19/17 <br />Policy Expiration Date: 08/19/18 <br />/le/i8 P4')e /a 5- <br />