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PF-15245a (05/07)© 2007 The Trust Page 1 of 1 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />Named Insured <br />Dr. Samantha B England <br />Endorsement Number <br />Policy Symbol <br />CRL <br />Policy Number <br />58G74115974 <br />Policy Period <br />09/11/2025 to 09/11/2026 <br />Effective Date <br />09/11/2025 <br />Issued By (Name of Insurance Company) <br />ACE American Insurance Company <br />Retroactive Date(s) <br />Designated Individual(s) or Entity(ies) <br />It is agreed that, in consideration of the premium charged, and solely with respect to the following designated individual(s) <br />or entity(ies), Item 4. of the Declarations, Retroactive Date, is deleted with respect to such designated individual(s) or <br />entity(ies) and replaced with the Retroactive Date for such designated individual(s) or entity(ies) listed in below. <br />Designated Individual(s) or Entity(ies)Retroactive Date(s) <br />Samantha B England 09/11/2023 <br />The premium for this endorsement is included in the <br />premium shown on the Declarations unless a <br />specific amount is shown here: <br />Additional Premium: <br />Return Premium: <br />All other terms and conditions of this policy remain unchanged. <br />________________________ <br />Authorized Agent <br />Docusign Envelope ID: 868EF087-BD0C-4926-8370-5D4A232273A6