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Insured Copy <br /> <br />ALL-24627 (01/08) <br />Policy Number <br />THIS ENDORSEMENT CHANGES THE POLICY. <br />PLEASE READ IT CAREFULLY. <br />COMMON POLICY CHANGE ENDORSEMENT <br />Endorsement No.: <br />Named Insured Endt Effective Date: <br /> <br />12:01 A.M., Standard Time <br />Agent Name <br />Agent No. Policy Eff Date: Policy Exp Date: <br />This endorsement will not be used to decrease coverages, increase rates or deductibles or alter any terms or <br />conditions of coverage unless at the sole request of the insured. <br />COVERAGE PART INFORMATION --- Coverage parts affected by this change as indicated by x below. <br /> Commercial Property <br /> Commercial General Liability <br /> Commercial Crime <br /> Commercial Inland Marine <br /> <br /> <br /> <br /> <br /> The following item(s): <br /> Insured’s Name Insured’s Mailing Address <br /> Policy Number Company <br /> Effective/Expiration Date Insured’s Legal Status/Business of Insured <br /> Payment Plan Premium Determination <br /> Additional Interested Parties Coverage Forms and Endorsements <br /> Limits/Exposures Deductibles <br /> Covered Property/Location Description Classification/Class Codes <br /> Rates Underlying Exposure/Insurance <br /> is (are) changed to read {See Additional Page(s)} <br />The above amendments result in a change in the premium as follows: <br />This premium does not include taxes and surcharges. <br /> No Changes To be Adjusted at Audit Additional Return <br />Tax and Surcharge Changes <br />Additional Return <br />Countersigned By: <br /> AUTHORIZED AGENT <br />OGLG71879562 <br />07/22/2023 07/22/2024 <br />07-22-23 <br />001 <br />278988 <br />TRUST RISK MANAGEMENT SERVICES INC DBA TRMS INSURA <br />KRISTY MATALA <br /> ACE American Insurance Company <br />X NO CHARGE <br />X NO CHARGE NO CHARGE <br />SEE NEXT PAGE <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />DocuSign Envelope ID: 7CBF367B-4F5C-4DA1-A542-6B5E57D6A1CD