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Hartford Casualty Insurance Company <br />Effective 6/1/17 to 6/1/18 <br />THIS ENDORSEMENT CHANGES THE POUCY. PLEASE READ IT CAREFULLY.. <br />NOTICE til:' CANCELLATION TO CERTIFICATE HOLDER($) <br />Folloyflumber AS W A04103 Eadorsernentliumber- <br />Eftefivedelta: 06/01117 Effk*m bwr Is the same as stated on the Wtrrnafion Pap of the pallay. <br />Named Insured and Address. WM-Z0tUMS;, INC. <br />1717 b=11MY AVE M 1400 <br />VALIAS, TZ 75202 <br />This pa[W is subloot to [he following addiftnat <br />Canditionsr <br />A. If this policy Is cancelled by the Company, other <br />than for non-payrroan! of premium, nolica of such <br />cancellation will be WDvided at least. thirty (313) <br />days In advance of #39 -cancelialion affeclivIe <br />date ta, the certiffroate holder(s) with; mailing <br />addresses an file with the e*nt of record or the <br />Company. <br />Ek ff this potfay is cancelled bye the Company for <br />non-payment of We rnlum. or by the Imsured, <br />rrafte of such canceltaftri wil be provided <br />vftln tart (10) days of -the cancialladoneffective, <br />date bo, the certiffeMa hordan(s) with smelling <br />addresses on file with the agent of record or the <br />Company. <br />Form WC 99933 94 Printed, k U.SA <br />process Date. 06/121117 <br />It notice is malfed, pnW of mai(Ing No the fast known <br />mailing address of the cedficale holder(s) on file <br />with the agent ff record or the Campany wM be <br />sufficrerd proof of notice. <br />Any natificalfon rights t provided by Ns endorsement. <br />apply only to saffireverillfwate bolder(s) who were <br />issued a ce-Mftate of insurance applicable b this <br />poli qfs term. <br />FaMwer to provide such notlae to the certiffoste <br />holder(s) will not anund or extend the date the <br />cancellation becomes. effective, nor will it negate <br />cancellalon of the polley. Failure to send notice <br />shall impose no liability of any kind upon the <br />Company or its agents criepresentalives. <br />Pailoy Expiration Date: 06/0111a <br />Q 21111. The l4arftrd <br />REVIEWED BY; EUNICE HEREDIA (PG 110F 2,D <br />