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F1 <br />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 />M Policy Number: 72 SBA UW5103 SC COPY <br />r <br />w <br />0 <br />Ln <br />Named Insured and Mailing Address; CALIFORNIA PROPERTY SPECIALISTS INC <br />SEE FORM IH1200 <br />600 W. SANTA ANA BLVD STE 115 <br />0 <br />0 <br />SANTA ANA CA 92701 <br />Ln <br />Policy Change Effective Date: 03/18/10 Effective hour is the same as stated in the <br />N Declarations Page of the Policy. <br />r <br />0 <br />o Policy Change Number: 005 <br />Agent Name: PETER C FOY & ASSOC INS SRVC INC <br />Code: 251697 <br />POLICY CHANGES: <br />HARTFORD CASUALTY INSURANCE COMPANY <br />I� ANY CHANGES IN YOUR PREMIUM WILL BE REFLECTED IN YOUR NEXT BILLING <br />STATEMENT. <br />THIS IS NOT A BILL. <br />ADDITIONAL PREMIUM DUE AT POLICY CHANGE EFFECTIVE DATE: $35.00 <br />*INCLUDES ADDITIONAL TERRORISM PREMIUM OF: $1.00 <br />RATES AND PREMIUMS ARE CHANGED. <br />FORM NUMBERS OF ENDORSEMENTS REVISED AT ENDORSEMENT ISSUE: <br />IH12001185 ADDITIONAL INSURED - STATE /POLITICAL SUBDIVISION <br />IH12001185 WAIVER OF SUBROGATION <br />PRO RATA FACTOR: 0.954 <br />THIS ENDORSEMENT DOES NOT CHANGE THE POLICY EXCEPT AS SHOWN. <br />Form SS 12 11 04 05 T Page 001 <br />Process Date: 03/23/10 <br />UW COPY <br />Policy Effective Date: 03/18/10 <br />Policy Expiration Date: 03/01/11 <br />