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10 <br /> POLICY NUMBER INSURED NAME AND ADDRESS <br /> B 5088073228 DAH CORPORATION <br /> 19119 NORTH CREEK PARKWAY <br /> SUITE 200 <br /> BOTHELL, WA 98011 <br /> POLICY CHANGES <br /> ENDORSEMENT EFFECTIVE 12/11/2012 <br /> This Change Endorsement changes the Policy. Please read it carefully. <br /> This Change Endorsement is a part of your Policy and takes effect on the <br /> effective date of your Policy, unless another effective date is shown. <br /> SB-147052-A <br /> (Ed. 03/06) <br /> This form has been added to the policy: <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> CHANGES - NOTICE OF CANCELLATION <br /> OR MATERIAL COVERAGE CHANGE <br /> This endorsement modifies insurance provided under the following: <br /> BUSINESSOWNERS COMMON POLICY CONDITIONS <br /> In the event of cancellation or material change that reduces or <br /> restricts the insurance afforded by this Coverage Part (other than <br /> the reduction of aggregate limits through payment of claims) , we <br /> agree to mail prior written notice of cancellation or material <br /> change to: <br /> SCHEDULE <br /> 1. Number of days required by state: 30 <br /> 2. Name: City of Everett <br /> 3. Address: Attn: IT Director <br /> 2930 Wetmore Avenue, Suite 6A <br /> Everett, WA 98201 <br /> Secretary <br /> Chairman of the Board <br /> G-56015-B (ED. 11/91) <br /> 82 <br />