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CNA Connect <br />Endorsement Declaration <br />POLICY NUMBER COVERAGE PROVIDED BY <br />B 6011408514 VALLEY FORGE INSURANCE COMPANY <br />333 S. WABASH <br />CHICAGO, IL. 60604 <br />INSURED NAME AND ADDRESS <br />HOLISTIC YOGA & HEALTH LLC <br />10015 GARDEN GROVE. BLVD <br />GARDEN GROVE, CA 92844 <br />AGENCY NUMBER AGENCY NAME AND ADDRESS <br />055542 EG INSURANCE AGENCY INC <br />616 S EUCLID ST <br />ANAHEIM, CA 92802 <br />Phone Number: (714)533-7089 <br />BRANCH NUMBER BRANCH NAME AND ADDRESS <br />240 LOS ANGELES <br />WEDBUSH CENTER <br />1.000 WILSHIRE BLVD 18 FL #1800 <br />LOS ANGELES, CA 90017 <br />Phone Number: (87'7)400-0750 <br />p. reecho?& CNA <br />�1 <br />FROM - POLICY PERIOD - TO <br />04/21/201.6 04/21./2017 <br />This policy becomes effective andexpires at 12:01 A.M. standard time at your mailing <br />address on the dates shown above. <br />This endorsement changes your policy. Please read te�ftSYly. <br />This Endorsement Results In No Change In Premiu eV�i <br />The Named Insured is a Limited Partnership. <br />Audit Period is Not Auditable <br />1 <br />A, ; I W4 SM <br />Gar � R r'�eat�o� <br />py-G <br />INSURED Page 1 of 3 <br />