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POLICY CHANGE DOCUMENT <br /> POLICY NO: CHANGE # 1 CHANGE EFFECTIVE: 02/01/2020 <br /> PHPK976044-007 <br /> Philadelphia Indemnity Insurance Company PRODUCER: Maguire Insurance Agency, Inc. FWI <br /> NAMED INSURED: Pilate Hottie, LLC. <br /> MAILING ADDRESS PO Box 911 <br /> Everett, WA 98206-0911 <br /> POLICY PERIOD: FROM 02/01/2020 TO 02/01/2021 at <br /> 12:01 A.M. Standard Time at your mailing address shown above. <br /> DESCRIPTION: <br /> In consideration of the premium reflected, the policy is amended as indicated below: <br /> Adding 1 additional insured: :City of Everett 2930 Wetmore Ave, Suite 8-A Everett WA 98201. <br /> Total Annual Total Prorate <br /> Additional/Return Premium $0.00 Additional/Return Premium $0.00 <br /> Total Annual Total Prorate <br /> Additional/Return Additional/Return <br /> Tax/Surcharge/Fee $0.00 Tax/Surcharge/Fee $0.00 <br /> Page 1 of 1 <br />