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1 <br />POLICY NUMBER: 6BRPG0000005895300 <br />INTERLINE <br />IL 12 0111185 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ai74111fE sENT <br />Policy Change <br />NIImhAr q <br />POLICY NUMBER <br />POLICY CHANGES EFFECTIVE <br />COMPANY <br />6BRPG0000005895300 <br />04/16/17 <br />Nationwide Mutual Insurance Company <br />NAMED INSURED <br />AUTHORIZED REPRESENTATIVE <br />Kevin Christian Noonchester <br />K&K Insurance Group, Inc. <br />DBA: NOTEWORTHY PUPPETS INC <br />COVERAGE PARTS AFFECTED <br />COMMERCIAL GENERAL LIABILITY COVERAGE <br />CHANGES <br />Form SRPG 8018 is added to the Policy <br />Cert # 1581 <br />14,- vl ��" <br />Authorized Representative Signature <br />IL 12 01 11 85 Copyright, Insurance Services Office, Inc., 1983 <br />Copyright, ISO Commercial Risk Services, Inc., 1983 <br />0 <br />Page 1 of 1 <br />