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POLICY NUMBER: 680-4H777478-21-47 <br />ISSUE DATE:1/28/2021 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />DESIGNATED ENTITY- NOTICE OF <br />CANCELLATIONMONRENEWAL PROVIDED BY US <br />This endorsement modifies insurance provided under the following: <br />ALL COVERAGE PARTS INCLUDED IN THIS POLICY <br />SCHEDULE <br />CANCELLATION: Number of Days Notice of Cancellation: 30 <br />NONRENEWAL: <br />PERSON OR <br />ORGANIZATION: <br />Number of Days Notice of Nonrenewal: 30 <br />ANY PERSON OR ORGANIZATION TO WHOM YOU <br />HAVE AGREED IN A WRITTEN CONTRACT THAT <br />NOTICE OF CANCELLATION OR NONRENEWAL OF THIS POLICY <br />WILL BE GIVEN, BUT ONLY IF: <br />1. YOU SEND US A WRITTEN REQUEST TO <br />PROVIDE SUCH NOTICE, INCLUDING THE <br />NAME AND ADDRESS OF SUCH PERSON OR <br />ORGANIZATION, AFTER THE FIRST NAMED <br />INSURED RECEIVES NOTICE FROM US OF <br />THE CANCELLATION OR NONRENEWAL OF THIS POLICY; AND <br />2. WE RECEIVE SUCH WRITTEN REQUEST AT <br />LEAST 14 DAYS BEFORE THE BEGINNING OF <br />THE APPLICABLE NUMBER OF DAYS SHOWN <br />IN THIS SCHEDULE. <br />ADDRESS: <br />THE ADDRESS FOR THAT PERSON OR ORGANIZ- <br />ATION INCLUDED IN SUCH WRITTEN REQUEST <br />FROM YOU TO US. <br />PROVISIONS: <br />A. If we cancel this policy for any statutorily permit- <br />ted reason other than nonpayment of premium, <br />and a number of days is shown for cancellation in <br />the schedule above, we will mail notice of cancel- <br />lation to the person or organization shown in the <br />schedule above. We will mail such notice to the <br />address shown in the schedule above at least the <br />number of days shown for cancellation in the <br />schedule above before the effective date of can- <br />cellation. <br />B. If we decide to not renew this policy for any statu- <br />torily permitted reason, and a number of days is <br />shown for nonrenewal in the schedule above, we <br />will mail notice of the nonrenewal to the person or <br />organization shown in the schedule above. We <br />will mail such notice to the address shown in the <br />schedule above at least the number of days <br />shown for nonrenewal in the schedule above be- <br />fore the expiration date. <br />IL T4 00 12 09 © 2009 The Travelers Indemnity Company <br />�oRaN <br />} z <br />a <br />wsknwaganertDMsiun <br />REVIEWED & APPROVED BY: <br />p R. VSA44a <br />Risk Management Analyst <br />