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WM 90 18 06 11 © 2011 Liberty Mutual Group of Companies Page 1 of 1 <br />Ed. 06/01/2011 All Rights Reserved <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />NOTICE OF CANCELLATION TO THIRD PARTIES <br />A.If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or <br />organizations shown in the Schedule below. We will send notice to the email or mailing address listed below at <br />least 10 days, or the number of days listed below, if any, before cancellation becomes effective. In no event <br />does the notice to the third party exceed the notice to the first named insured. <br />B.This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to <br />provide such advance notification will not extend the policy cancellation date nor negate cancellation of the <br />policy. <br />SCHEDULE <br />Name of Other Person(s) / Email Address or mailing address: Number Days Notice: <br />Organization(s): <br />Per schedule on file with broker Per schedule on file with broker 30 days <br />All other terms and conditions of this policy remain unchanged. <br />Effective Date 10/01/2023 Premium $ <br />Issued by LM Insurance Corp. <br />For attachment to Policy No. WA5-66D-067353-013 <br />Issued to <br />Docusign Envelope ID: AE6D62F6-F8A3-4FE3-ABFB-CC69763A0B44