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' ' PolicyChange : <br /> THE Business Owner's Policy <br /> HARTFORD <br /> Policy Number: 37 SBM AH5NHB Insurer: <br /> Hartford Underwriters Insurance Company, a <br /> Policy Period: 09/21/2020 to 09/21/2021 property and casualty company of The <br /> Hartford <br /> Named Insured and Mailing Address: <br /> Isabella Valencia, One Hartford Plaza, Hartford, CT 06155 <br /> Black Lab Gallery, <br /> 1618 HEWITT AVE, Name of Agent/Broker: <br /> EVERETT, WA 98201-3516 MYLO LLC/PHS <br /> 8800 WARD PARKWAY STE 200 <br /> Policy Change Number: 1 KANSAS CITY, MO 64114 <br /> Policy Change Effective Date: 10/26/2020, Code: 37277676 <br /> Effective hour is the same as stated in the <br /> Declarations Page of the Policy. <br /> Coverage Parts Affected: <br /> Common <br /> Liability <br /> This is NOT a bill. However, any changes in your premium will be reflected in your next billing <br /> statement. You will receive a separate bill from The Hartford. If you are enrolled in repetitive EFT <br /> draws from your bank account, changes in premium will change future draw amounts. <br /> As a result of the changes described herein. there is no change in $0 <br /> premium. <br /> *Price is subject to fees and surcharges <br /> Countersigned by: Ft-e-z cr3� Gqa ,z�-�Q , 10/26/2020 <br /> Authorized Representative Date <br /> Form SC 00 06 10 18 Page 1 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 />