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OLD REPUBLIC GENERAL INSURANCE CORPORATION <br />CANCELLATION OR NON -RENEWAL TO SPECIFIED PERSONS OR <br />ORGANIZATIONS ENDORSEMENT <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: <br />BUSINESS AUTO COVERAGE FORM <br />COMMERCIAL GENERAL LIABILITY COVERAGE FORM PART <br />OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE <br />PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART <br />RAILROAD PROTECTIVE LIABILITY COVERAGE PART <br />If we cancel or non -renew this policy for any reason other than non-payment, we will deliver notice of the <br />cancellation or non -renewal to all Specified Persons or Organizations on file with us Thirty ( 30 ) days <br />prior to the effective date of cancellation or non -renewal. <br />If we cancel this policy for non-payment, we will deliver notice of the cancellation to all Specified Persons or <br />Organizations on file with us Ten ( 10 ) days prior to the effective date of cancellation. <br />If notice is mailed, proof of mailing will be sufficient proof of notice. <br />Named Insured <br />O' GRADY PAVING, INC. <br />Policy Number <br />AlCA44181801 <br />Endorsement No. <br />000 <br />Policy Period <br />07/01/2019 to 07/01/2020 <br />Endorsement Effective Date: <br />07/01/2019 <br />Producer's Name: <br />OLD REPUBLIC CONTRACTORS INSURANCE AGENCY, INC. <br />Producer Number: <br />7000 <br />1" <br />AIAI'a <br />07/01/2019 <br />AUTHORIZED REPRESENTATIVE DATE <br />IL EN GN 0004 09 11 Page 1 of 1 <br />55499974 1 OGRAPAV-Cl 1 19-20 WC, Auto, GL, XS I Bolton Certificate Processing 1 5/15/2020 5:47:20 PM (PDT) I Page 3 of 9 <br />