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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> POLICY CHANGE ENDORSEMENT - # 1 <br /> 011 <br /> Certificate/Policy Number Policy Change Effective Company <br /> CPS3323287 10/15/2020 at 12:01 a.m. Scottsdale Insurance Co. <br /> Named Insured <br /> Writhe Pole Dance, LLC <br /> 9823 64th Dr NE <br /> Marysville, WA 98270 <br /> CHANGES <br /> In consideration of the premium charged, it is understood and agreed that the following change(s) is made to this policy: <br /> The City of Everett is hereby listed as Additional Insured per form CG2012(12/19). <br /> There are no further changes to this policy. <br /> "This contract is registered and delivered as a surplus line coverage under the insurance code of the state of <br /> Washington,Title 48 RCW.It is not protected by any Washington state guaranty association law." GRIFFIN <br /> UNDERWRITING SERVICES <br /> ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. <br /> Submission#:20202776A <br /> Date of Issue:Oct 15.2020 <br /> Issued By:Gpoe <br /> IL 12 01 1185 (Ike/ a <br /> Authorized Representative Signature <br /> Griffin Underwriting Services <br /> cc: Klein Insurance Agency Inc In CA.DBA:Griffin Insurance Services <br /> 3131 Smokey Point Dr Suite 7 <br /> Arlington,WA 98223 <br />