AARP_Foundation_-_Endorsement_2.pdf

FAIC-SKLBUS-COCHG (6/01)

Policy Number

THIS ENDORSEMENT CHANGES THE POLICY.

PLEASE READ IT CAREFULLY.

COMMON POLICY CHANGE ENDORSEMENT

Endorsement No.

Named Insured Effective Date:

12:01 A.M., Standard Time

Agent Name Agent No.

This endorsement will not be used to decrease coverages, increase rates or deductibles or alter any terms or conditions of coverage unless at the sole request of the insured.

COVERAGE PART INFORMATION ---- Coverage parts affected by this change as indicated by x below.

Commercial Property

Commercial General Liability

Commercial Crime

Commercial Inland Marine

The following item(s):

Insured’s Name Insured’s Mailing Address

Policy Number Company

Effective/Expiration Date Insured’s Legal Status/Business of Insured

Payment Plan Premium Determination

Additional Interested Parties Coverage Forms and Endorsements

Limits/Exposures Deductibles

Covered Property/Location Description Classification /Class Codes

Rates Underlying Exposure/ Insurance is (are) changed to read {See Additional Page(s) }

The above amendments result in a change in the premium as follows:

This premium does not include taxes and surcharges.

No Changes To be Adjusted at Audit Additional Return

Tax and Surcharge Changes

Additional Return

Countersigned By:

AUTHORIZED AGENT

11CAB4937016

07-01-23

14055 LOCKTON COMPANIES, LLC (NORTHEAST SERIES)

AARP

ARCH INSURANCE COMPANY

X COMMERCIAL AUTOMOBILE NO CHARGE

X NO CHARGE NO CHARGE

THE FOLLOWING FORM(S) HAS BEEN ADDED:

00 CA0070 00 10-13 ADDTL INSURED - DESIGNATED PERSON OR ORG

ALL OTHER TERMS AND CONDITIONS REMAIN THE SAME

Endorsement Number: 002

Policy Number: 11CAB4937016

Named Insured: AARP

This endorsement is effective on the inception date of this Policy unless otherwise stated herein:

Endorsement Effective Date: 7/1/2023

00 CA0070 00 10 13 Page 1 of 1

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED – DESIGNATED PERSON OR ORGANIZATION

This endorsement modifies insurance provided under the following:

AUTO DEALERS COVERAGE FORM

BUSINESS AUTO COVERAGE FORM

MOTOR CARRIER COVERAGE FORM

SCHEDULE

Name of Person(s) or Organization(s):

THE STATE OF ARIZONA, AND ITS DEPARTMENTS,AGENCIES, BOARDS,

COMMISSIONS, UNIVERSITIES, OFFICERS, OFFICIALS, AGENTS, AND

EMPLOYEES AS ADDITIONAL INSUREDS WITH RESPECT TO LIABILITY

ARISING OUT OF THE ACTIVITIES PERFORMED BY OR ON BEHALF OF THE

CONTRACTOR INVOLVING AUTOMOBILES OWNED HIRED AND/OR NON-OWNED

BY THE CONTRACTOR.

With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.

Under Covered Autos Liability Coverage, the Who is An Insured provision is amended to include as an “insured” the person(s) or organization(s) named in the Schedule above, but only with respect to their legal liability for your acts or omissions or acts or omissions of any person for whom Covered Auto Liability Coverage is afforded under this policy.

All other terms and conditions of this Policy remain unchanged.