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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: 52 SBA R09216 DX <br />Named Insured and Mailing Address; SELECTRON TECHNOLOGIES, INC. <br />SEE FORM SS1235 <br />12323 SW 66TH AVE <br />PORTLAND OR 97223 <br />Policy Change Effective Date: 05/21/21 Effective hour is the same as stated in the <br />Declarations Page of the Policy. <br />Policy Change Number: 005 <br />Agent Name: W B ADAMS CO/PHS <br />Code: 700991 <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 />FORM NUMBERS OF ENDORSEMENTS REVISED AT ENDORSEMENT ISSUE: <br />IH12001185 SCHEDULE OF FINE ARTS <br />THIS ENDORSEMENT DOES NOT CHANGE THE POLICY EXCEPT AS SHOWN. <br />Form SS 12 1104 05 T Page oo1 �kM�go Mn� <br />Process Date: 05/24/21 Policy Effective y RENIAMvwgnadDJBC <br />Policy Expiratio fu,.« R, vsa <br />A�Qmm—, Risk Management Malyst <br />