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PolicyChange : <br /> THE "�D Business Owner's PolicyHARTFORD <br /> The following Additional Insured has been added as an Additional Insured- State or Governmental <br /> Agency or Subdivision or Political Subdivision- Permits or Authorizations. <br /> Additional Insured Name <br /> The City Of Everett <br /> Policy is amended to add the following Endorsement Forms reflecting the changes made to your policy. <br /> FORM NUMBER FORM NAME COVERAGE PART <br /> SC 00 06 10 18 POLICY CHANGE Common <br /> ADDITIONAL INSURED-STATE OR <br /> GOVERNMENTAL AGENCY OR <br /> SL 3040 10 18 SUBDIVISION OR POLITICAL Liability <br /> SUBDIVISION-PERMITS OR <br /> AUTHORIZATIONS <br /> Premium associated with this Policy Change has pro rata factor 0.904. <br /> Form SC 00 06 10 18 Page 2 of 2 <br /> Process Date: 10/26/2020 ©2018, The Hartford Policy Expiration Date: 09/21/2021 <br /> (May include copyrighted material of Insurance Services Office, Inc., with its permission) <br />