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Policy Number <br /> (25)7365-74-83 <br /> COMMON POLICY CHANGE ENDORSEMENT <br /> Endorsement No. 001 <br /> Named Insured TRB AND ASSOCIATES Effective Date: 11-10-2025 <br /> 12:01 A.M., Standard Time <br /> Agent Name THE LIBERTY COMPANY INSURANCE BROKERS Agent No. 06647-999 <br /> LLC <br /> This endorsement will not be used to decrease coverages, increase rates or deductibles or alter any terms or <br /> conditions of coverage uniess at the sole re nest of the insured. <br /> COVERAGE PART INFORMATION —Coverage ,Parts affected by this change as indicated by 0 below. <br /> Commercial Property <br /> Commercial General Liability <br /> Commercial Crime <br /> Commercial Inland Marine <br /> COMMERCIAL AUTOMOBILE NO CHARGE <br /> The following item(s): <br /> Insured's Name Insured's Mailing Address <br /> Policy Number Company <br /> Effective/Expiration Date a Insured's Legal Status/Business of Insured <br /> Payment Plan F-1 Premium Determination <br /> Additional Interested Parties Coverage Forms and Endorsements <br /> Limits/Exposures Deductibles <br /> Covered Property/Located Description ❑ Classification/Class Codes <br /> Rates Underlying Exposure <br /> is (are) changed to read (See Additional Page(s)) <br /> THE POLICY IS AMENDED AS FOLLOWS : <br /> ADD AI <br /> THE FOLLOWING FORM (S) HAS BEEN ADDED: <br /> CA 20 48 10-13 DESIGNATED INSURED <br /> ALL OTHER TERMS AND CONDITIONS REMAIN THE SAME <br /> The above amendments result in a change in the premium as follows: <br /> This premium does not include taxes and surcharges. <br /> M No Changes JEJ To be Adjusted at Audit I Additional NO CHARGE ReturnNO CHARGE <br /> Tax and Surcharge Changes <br /> Additional Return <br /> AUTHORIZED AGENT <br /> 16-02-0212(01/97) <br />