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0 <br />Notification to Others of Cancellation, Nonrenewal or ZURICH <br />Reduction of Insurance <br />Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. AddT Prem Return Prem. <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />This endorsement modifies insurance provided under the: <br />Commercial General Liability Coverage Part <br />,Liquor Liability Coverage Part <br />Products/ Comp) W Operations Liability Coverage Part <br />A. If we cancel or non -renew this Coverage Part(s) by written notice to the first Named Insured for any reason other than <br />nonpayment of premium, we will mail or deliver a copy of such written notice of cancellation or non -renewal: <br />1. To the name and address corresponding to each person or organization shown in the Schedule below; and <br />2. At least 10 days prior to the effective date of the cancellation or non -renewal, as advised in our notice to the first <br />Named Insured, or the longer number of days notice if indicated in the Schedule below. <br />B. If we cancel this Coverage Part(s) by written notice to the first Named Insured for nonpayment of premium, we will <br />mail or deliver a copy of such written notice of cancellation to the name and address corresponding to each person or <br />organization shown in the Schedule below at least 10 days prior to the effective date of such cancellation. <br />C. If coverage afforded by this Coverage Part(s) is reduced or restricted, except for any reduction of Limits of Insurance <br />due to payment of claims, we will mail or deliver notice of such reduction or restriction: <br />1. To the name and address corresponding to each person or organization shown in the Schedule below; and <br />2. At least 10 days prior to the effective date of the reduction or restriction, or the longer number of days notice if <br />indicated in the Schedule below. <br />D. If notice as described in Paragraphs A., B. or C. of this endorsement is mailed, proof of mailing will be sufficient proof <br />of such notice. <br />SCHEDULE <br />Name and Address of Other Perso(s) / Organization(s): <br />Number of <br />Days Notice: <br />OFFICE OF SURFACE MINING RECLAMATION <br />30 <br />AND ENFORCEMENT, WESTERN REGION <br />1999 BROADWAY, SUITE 3320 <br />DENVER, CO 80202— 3050 <br />All other terms and conditions of this policy remain unchanged. <br />U -Ci -1447-A CW (05/10) <br />Page 1of1 <br />Includes copyrighted material of Insurance Services Office, Inc., with its permission. <br />