**Endorsement #3**

The following spaces preceded by an asterisk (*) need not be completed if this endorsement and the policy have the same inception date.

**ATTACHED TO AND FORMING PART OF POLICY NO.:** 565XAO/92  
**REACTIVE DATE OF ENDORSEMENT:**  
**ISSUED TO:**  

It is understood and agreed that wherever the word "Primary Insurance" or "Primary Insurer" appear in this policy such words are amended to read "Underlying Excess Insurance" or "Underlying Excess".

Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, provisions, agreements or limitations of the above mentioned Policy, other than as above stated.

**Agency Name and Address**

In Witness Whereof, the Company has caused this endorsement to be signed by its President at St. Paul, Minnesota and countersigned by a duly authorized representative of the Company.
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This document appears to be an endorsement form from The St. Paul Companies, detailing changes to the policy language regarding the primary insurer. It also includes a statement that the endorsement does not alter the terms of the original policy unless specifically noted.