**Endorsement #11**

| Policy No | Effective Date | Agency No | Add'l Premium | Return Premium |
|-----------|---------------|-----------|---------------|----------------|
| 8506100   |               |           | $             | $              |

**Named Insured:**

This endorsement is issued by the company named below, which is the insurer under the policy designated above issued to the Named Insured and forms a part of said policy as of the effective date hereof, at the hour stated in the policy Declarations.

**It is agreed that the premiums indicated are estimated and that they shall be adjusted in accordance with manual rates and are subject to the attachment of schedules, etc., at a later date.**

**Zurich Insurance Company**
**American Guaranty & Liability Insurance Company**

**Counter-signed:**
**Vital Nigro** (Attorney)
**Munoz & Kell**

**United States Manager - Zurich**
**President - American Guaranty**

**Form 116-G**
**Z 006892**