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SPECTRUM POLICY DECLARATIONS (Continued) <br /> POLICY NUMBER: 57 SBA BM1263 <br /> LOSS PAYEE CITIZENS BUSINESS BANK ITS SUCCESSO <br /> FORM SS 12 12 R <br /> PO BOX 390785 <br /> MINNEAPOLIS, MN. 55439 <br /> PROPERTY: BPP <br /> LOSS PAYEE PITNEY BOWES GLOBAL FINANCIAL <br /> FORM SS 12 12 27 WATERVIEW DR <br /> SHELTON, CT. 06484 <br /> PROPERTY: BPP <br /> Form Numbers of Forms and Endorsements that apply: <br /> SS 00 01 03 14 SS 00 05 10 08 SS 00 07 07 05 SS 00 08 04 05 <br /> SS 00 45 12 06 SS 00 60 09 15 SS 00 61 07 19 SS 00 64 09 16 <br /> SS 84 01 09 07 SS 41 70 06 11 SS 41 71 12 19 SS 01 21 02 20 <br /> SS 42 06 03 17 SS 04 08 09 07 SS 04 19 04 09 SS 04 22 07 05 <br /> SS 04 30 07 05 SS 04 38 09 09 SS 04 39 07 05 SS 04 41 03 18 <br /> SS 04 42 03 17 SS 04 44 07 05 SS 04 45 07 05 SS 04 46 09 14 <br /> SS 04 47 04 09 SS 04 80 03 00 SS 04 86 03 00 SS 40 18 07 05 <br /> SS 40 26 03 17 SS 40 50 10 08 SS 40 93 07 05 SS 41 12 06 22 <br /> SS 41 51 10 09 SS 41 63 06 11 IH 10 01 09 86 SS 05 47 09 15 <br /> SS 51 11 03 17 0-4190-0 IH 12 05 02 21 SS 12 12 03 92 <br /> SS 12 15 03 00 SS 50 19 01 15 IH 99 40 04 09 IH 99 41 04 09 <br /> SX 80 01 06 97 SS 83 76 01 15 SS 89 93 07 16 SS 12 23 06 11 <br /> IH 12 00 11 85 ADDITIONAL INSURED - PERSON-ORGANIZATION <br /> IH 12 00 11 85 WAIVER OF SUBROGATION <br /> IH 12 00 11 85 ENDORSEMENT #008 EFFECTIVE DATE 02/05/2021 <br /> IH 12 00 11 85 ENDORSEMENT #011 EFFECTIVE DATE 03/10/2021 <br /> IH 12 00 11 85 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTOR <br /> - SCHEDULED PERSON OR ORGANIZATION <br /> Risk Management Division <br /> .= REviEw c&APPROVED BY: <br /> A Amek <br /> • <br /> Risk Management Specialist <br /> Form SS 00 02 12 06 Page 014 / <br /> Process Date: 0 7/2 5/2 3 Pol icy Expiration Date: 10/12/2 4 <br />