# Non-Premium Endorsement

**Issued by:** City Insurance Company
**Policy Number:** HEC 9 82 60 69
**Effective Date and Time of Policy:** 5/21/79
**Producer:** Johnson & Higgins

**Endorsement No.:** 7
**Endorsement Date:** 9/17/79
**Endorsement Expiration:** 5/21/80
**Producer No.:** OPC 50138-081

It is agreed that this policy is hereby extended as an extension. All other terms and conditions of this policy remain unchanged.

In consideration of the premium charged, it is agreed that Item No. 2 and 3, Primary or Underlying Insurance Carrier, is amended to read as follows:

**Centennial Insurance Co.**
**Policy No.:** 462018623

**Signature of Authorized Representative:**