GENERAL CHANGE ENDORSEMENT - FEMA.gov · 2012-07-19 · General Change Endorsement and additional...

END 1 May 1, 2005

GENERAL CHANGE ENDORSEMENT

The NFIP General Change Endorsement formcannot be used to renew, extend, or change apolicy term. However, the General ChangeEndorsement form, or a similar form for WYOcompanies, can be used to make certain typesof coverage and rating changes or corrections toexisting policy data.

I. ENDORSEMENT RULES

A. Coverage Endorsements

1. Additional Coverage or Increase in Amountof Insurance

Added coverage, or an increase in theamount of insurance, is permitted at anytime during a policy term. The additionalpremium is calculated pro rata for thebalance of the policy term, at either therate in effect on the endorsementeffective date or the rate in effect on thepolicy effective date, in accordance witheach WYO company’s standard businesspractice. (See Examples 1 through 4 atthe end of this section.) Refer to theGeneral Rules section, page GR 7, forthe applicable waiting period.

2. Reduction of Insurance

A reduction in the amount of buildinginsurance cannot be made unless part ofthe building has been removed, whichreduces the building’s value to less thanthe amount of the building insurance, ora current appraisal or cost estimate isprovided which shows that the building’scurrent coverage amount is higher thanthe estimated replacement cost of thebuilding. (See Example 6 at the end ofthis section.)

A reduction in the amount of contentsinsurance cannot be made unless someof the contents have been sold orremoved, which reduces the contents’value to less than the amount of thecontents insurance.

3. Removal of a Coverage

There is no return premium for theremoval of building or contents coverageunless the property is no longer at thedescribed location or the property of thepolicyholder. (See Example 5 at the endof this section.)

B. Rating Endorsements

1. Rate Reduction

It is not permissible to revise a policy'srating during a policy term, due to a ratedecrease, unless the effective date of therate change is prior to the policy's effectivedate.

2. Rating Error

The NFIP rules require that the policy mustbe in effect in order to process refunds.

a. Current Term Refunds

Corrections will be allowed for only thecurrent year for failure of the WYOcompany or NFIP Direct to:

� Use the map grandfather rule.

� Use the V-Zone Risk Factor RatingForm. The endorsement effectivedate is either the date the V-ZoneRisk Factor Rating Form wascertified or the effective date of thecurrent policy year, whichever islater.

� Make a timely revision of alternativerates (rates used for Pre-FIRM ratedrisks where the zone is unknown).

� Use Post-FIRM rating for a Pre-FIRM structure. The refund will beprocessed if the insured provides anElevation Certificate. The endorse-ment effective date is the effectivedate of the current policy year.

� Use an Elevation Certificate onPost-FIRM buildings rated using“Without Certification of Complianceor Elevation Certificate” for ZonesAO and AH, or “No ElevationCertificate or No Estimated BFE” forUnnumbered A Zone. The en-dorsement effective date is theeffective date of the current policyterm.

b. Current and One Prior Term Refunds

Premium refunds will be allowed for thecurrent and 1 prior policy year when anincorrect flood zone and/or Base Flood

END 2 May 1, 2005

Elevation was used at the time thepolicy was issued and the current FIRMshows a more hazardous zone orhigher Base Flood Elevation.

3. Revision of an Alternative Rating

Alternative rating is used to compute thepremium on a Renewal Notice followingconversion of a community from theEmergency Program to the RegularProgram. Alternative rates are also usedby producers for the rating of Pre-FIRMconstruction. Alternative rating allows theproducer and the policyholder 1 year torevise the rating, so a premium refundcan be obtained from the renewal orinception date if it is determined that theinsured property is located in a lowerrated zone. During subsequent policyterms, such revisions may also be madeeffective with the start of the policy term.

4. Map Revision

A map change (reprinting, Letter of MapAmendment [LOMA], Letter of MapRevision [LOMR], or Letter of Determi-nation Review [LODR]) may change theflood zone in which a property is located toa lower rated zone, or it may change theBase Flood Elevation. In such cases, thepolicy rating may be revised for the currentand prior policy years if the changeoccurred prior to the current policy year.

When a community has been convertedfrom the Emergency Program to theRegular Program, the policy rating may berevised to reflect the correct flood zone.However, no premium refund is allowed onpremium previously paid.

C. Misrated Policy

Premium refunds will be allowed with properdocumentation (see III.B.2.a.) going back amaximum of 6 calendar years when there wasa misrating such as an incorrect buildingdescription, lowest floor elevation, communitynumber, flood zone, or Base Flood Elevation,so long as the insured can provide proof ofthe misrating.

The flood zone and Base Flood Elevation canonly be corrected using the current FIRM.

Any lapse in coverage does not extend thenumber of years the premium refund isallowed.

D. Conversion of Standard Rated Policy toPRP Due to Misrating or Map Revision

A policy written as a Standard B, C, or X Zonepolicy and later found to be eligible for a PRPmay be endorsed or rewritten as a PRP for onlythe current policy term.

When the risk has been rated with other than B,C, or X Zone rates, but is later found to be in aB, C, or X Zone and eligible for a PRP, thewriting company will be allowed to endorse orcancel/rewrite up to 6 years.

The policy may be canceled/rewritten usingCancellation Reason Code 22 if both of thefollowing conditions are met:� The request to endorse or cancel/rewrite the

policy is received during the current policyterm.

� The policy has no open claim or closed paidclaim.

The new PRP building coverage will be equaleither to the building limit issued under theStandard B, C, or X Zone policy or the nexthigher limit available under the PRP if there isno PRP option equal to the Standard B, C, or XZone building limit.

E. Changing Deductibles

Increasing deductibles is permitted during thecurrent policy term. (See Example 7 at the endof this section.) Deductibles cannot be reducedmid-term, unless required by the mortgagee andwritten authorization is provided by themortgagee. A 30-day waiting period will applyunless the request to reduce the deductible is inconnection with making, extending, or renewinga loan.

The ICC premium is not eligible for thedeductible discount or surcharge. First calculatethe deductible discount or surcharge, then addin the ICC premium, for each policy year.

F. Correcting Property Address

A policy cannot be endorsed to change thelocation. This includes relocation from one unitto another unit in the same building.

However, an erroneous address (e.g., throughtypographical error) can be corrected throughendorsement. The agent must provide proof or areasonable explanation for the error.

END 3 October 1, 2005

II. ENDORSEMENT PROCESSING PRIORTO POLICY RENEWAL (NFIP DIRECTBUSINESS ONLY)

A. During Last 90 Days of Policy Term

1. If the premium payment for renewal of thepolicy has not already been processed bythe NFIP, a General Change Endorsementprocessed will produce a revised RenewalNotice for the upcoming term.

2. If the original Renewal Notice has not beenpaid, the payor may use the revisedRenewal Notice or subsequent FinalNotice.

B. During Last 75 Days of Policy Term

1. If the original Renewal Notice has not beenpaid, the producer must submit the GeneralChange Endorsement for the current policyterm only and submit a renewal Applicationfor the upcoming term. A separate premiumpayment must be submitted for eachtransaction. (The insured and/or mort-gagee, if payor, should be advised not topay the Renewal Notice or Final Noticewhen a renewal Application and premiumhave been submitted.)

2. If the original Renewal Notice has beenpaid, the producer must submit the GeneralChange Endorsement together with anyrequired additional premium for the renewalpolicy term and, if applicable, a separateGeneral Change Endorsement andadditional premium for the remainder of thecurrent policy term. The effective date ofthe endorsement to increase coverage (upto the inflation factor) will be the “renewaldate” only if the endorsement andadditional premium are received within the30-day grace period.

C. Refunds Generated from EndorsementProcessing

The return premium is based on rates in effecton the effective date of the change or the policyeffective date, in accordance with the WYOcompany’s standard business practice. It iscalculated by revising the rate, effective from theinception date of the current policy term,provided the inception date is on or after thecommunity conversion date.

The Federal Policy Fee and ProbationSurcharge (if applicable) are not subject tocalculation of return premiums.

III. PREPARATION OF FORM

A. General Instructions

Endorsements are processed by submitting acompleted General Change Endorsement formand proper documentation (see III.B.2.a.) to thewriting company.

Instructions for completing the General ChangeEndorsement form are self-explanatory. Thefollowing items are of special note:

� The policy term cannot be changed. Allcalculations must reflect the policy termshown on the current declarations page.

� A geographic location must be given for aproperty. For example, the insured's mailingaddress may be shown as:

Route 4Box 179Danville, Ohio 43014

The property location should be completedas: Farmhouse on the north side of U.S. 70,6 miles west of Danville, Ohio 43014.

� The contents location section should becompleted if contents coverage is beingadded/deleted or if the location of thecontents being insured within the describedbuilding has changed. Provide anexplanation of the change of location in thedescription area of the section.

� The insured must sign and date the GeneralChange Endorsement form whenever thereis a request to reduce policy limits, makepolicy assignment, or change the agent ofrecord.

B. Refund Processing Procedures

1. The current NFIP insurer (WYO Company orDirect Business) will be responsible forreturning the premium for the current andprior policy year, provided that it was theinsurer for that period. If another NFIPinsurer was the insurer for the prior policyyear, it will be responsible for returning thepremium for that year. Agents submitrequests to their carrier.

2. Requests for refunds for more than 2 yearsmust be processed by the NFIP Bureau.

a. For requests processed by the Bureau,the current NFIP insurer must submit allof the documentation necessary to

END 4 May 1, 2005

make a refund for any period exceeding2 years. At a minimum, this documen-tation will consist of the following:

� The company’s statistical records ordeclarations pages for each policyterm and evidence of premiumpayments obtained from the insuredif these documents are not availablefrom the company’s records.

� An endorsement request for eachyear and the premium refundcalculation for each year that thecompany had the policy.

� A Letter of Map Amendment(LOMA); a Letter of Map Revision(LOMR); a Letter of DeterminationReview (LODR); a copy of the mostrecent flood map marked to showthe exact location and flood zone ofthe building; a letter indicating theexact location and flood zone of thebuilding, and signed and dated by alocal community official; an Ele-vation Certificate indicating the

exact location and flood zone of thebuilding, and signed and dated by asurveyor, engineer, architect, orlocal community official; or a floodzone determination certification thatguarantees the accuracy of theinformation.

b. In order for the Bureau to process arefund request, the appropriatedocumentation must be mailed directlyto the NFIP Bureau and StatisticalAgent, Underwriting Department, P.O.Box 310, Lanham, MD 20703.

3. WYO Companies will be notified of thepremium refunded and the ExpenseAllowance due to the NFIP. The companiesmust maintain this documentation as part oftheir underwriting files.

4. Any lapse in coverage does not extend thenumber of years the premium refund isallowed.

The Bureau will return to the sender anyunauthorized refund requests for more than2 years.

END 5 May 1, 2005

IV. ENDORSEMENT RATING EXAMPLES

TABLE OF CONTENTS

EXAMPLE PAGE

Example 1 Increasing Coverage on a Preferred Risk Policy ..................................... END 6

Example 2 Increasing Coverage, Program Conversion............................................. END 7

Example 3 Increasing Coverage................................................................................ END 8

Example 4 Increasing Coverage After a Rate Change.............................................. END 9

Example 5 Removing Contents.................................................................................. END 10

Example 6 Reducing Building Coverage ................................................................... END 11

Example 7 Increasing Deductible............................................................................... END 12

END 6 May 1, 2005

EXAMPLE 1

INCREASING COVERAGE ON A PREFERRED RISK POLICY

� Policy term is October 15, 2004-2005 � Pre-FIRM, X-Zone, with basement � Present coverage:

Building $75,000/Contents $30,000 � Premium at policy inception was $232. � Endorsement effective date is June 2, 2005. � Coverages added are $125,000 on the building

and $50,000 on the contents for a total of$200,000 on the building and $80,000 on thecontents.

� Rates in effect on the effective date of the policyare to be used in calculating the premiums.

� The difference between these two premiums is

$99.

� Prorate the difference using the pro rata factorbelow:

Time period is June 2, 2005,to October 15, 2005Number of days is 135Pro rata factor is .370

INSURANCECOVERAGE

SECTION ACURRENT COVERAGE

SECTION B+ INCREASED — DECREASED COVERAGE

ONLY

NEWPREMIUMTOTALS

AMOUNT RATE PREMIUM AMOUNT RATE PREMIUMBUILDING BASIC 75,000 � 232 125,000 � 331 331

BUILDINGADDITIONAL

�

CONTENTS BASIC 30,000 50,000 �

CONTENTSADDITIONAL

�

IF CHANGING AMOUNT OF INSURANCE, ENTER NEW TOTAL AMOUNT BELOW PAYMENTOPTION: SUBTOTAL 331

BUILDING COVERAGE CONTENTS COVERAGE� CREDIT CARD

DEDUCT.DISCOUNT/SURCHARGE �

BASIC ADDITIONAL TOTAL BASIC ADDITIONAL TOTAL � OTHER: SUBTOTAL 331

200,000 80,000 _________ ICC PREMIUM�

SUBTOTAL 331IF RETURN PREMIUM, MAIL REFUND TO: � INSURED � AGENT � PAYOR. THE ABOVE CRS PREMIUM DISCOUNT ____%

�

STATEMENTS ARE CORRECT TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT SUBTOTAL 331ANY FALSE STATEMENTS MAY BE PUNISHABLE BY FINE OR IMPRISONMENT UNDERAPPLICABLE FEDERAL LAW.

PREMIUM PREVIOUSLY PAID

(Excludes Probation Surcharge/Federal Policy Fee) 232DIFFERENCE + (+/-) +99

SIGNATURE OF INSURED AND DATE SIGNATURE OF INSURANCE AGENT/BROKER DATE (MMDDYY) PRO RATA FACTOR .370TOTAL (+/-) +37

END 7 May 1, 2005

EXAMPLE 2

INCREASING COVERAGE, PROGRAM CONVERSION

� Policy term is January 15, 2006-2007 � Single family dwelling, no basement, Pre-FIRM � Present coverage: Building $35,000/

Contents $10,000 � Policy conversion date from Emergency to

Regular Program: July 15, 2006 � Building located in an A99 Zone � Premium rates are: Building .64/.14, Contents

.99/.25. � Endorsement effective date is August 14, 2006.

(The Emergency Program premiums that alreadyexist on this policy are earned for the remainderof the policy term; they are not refundable.)

� The coverages being added are $50,000 on the

building and $15,000 on the contents for a total of$85,000 on the building and $25,000 on thecontents; and $30,000 coverage for ICC.

� To increase coverage, complete Sections A

and B. Section A is for current coverage,Section B should show only the amounts of theincreases.

� $15,000 of the $50,000 coverage to be added on the

building must be calculated in the “Amount” column

under Section B, “Increased-Decreased CoverageOnly” (using the applicable rate) to amend thepresent coverage to the threshold for the RegularProgram basic limits.

� $10,000 of the $15,000 coverage to be added on

the contents must be calculated under the“Amount” column under Section B, “Increased-Decreased Coverage Only” (using the applicablerate) to amend the present coverage to thethreshold for the Regular Program basic limits.

� Add Sections A and B premiums to obtain the

New Premium Subtotals. � Add the ICC premium, which was not paid in the

Emergency Program. � The Premium Previously Paid is $362 (excluding

ICC/Probation Surcharge/Federal Policy Fee). � Subtract the Premium Previously Paid from the

Premium Total to obtain the Difference(additional/return premium).

� Prorate the Difference

Time period is August 14, 2006,to January 15, 2007Number of days is 154Pro rata factor is .422

INSURANCECOVERAGE



ONLY

NEWPREMIUMTOTALS

AMOUNT RATE PREMIUM AMOUNT RATE PREMIUMBUILDING BASIC 35,000 .76 266 15,000 .64 96 362

BUILDINGADDITIONAL

35,000 .14 49 49

CONTENTS BASIC 10,000 .96 96 10,000 .99 99 195

CONTENTSADDITIONAL

5,000 .25 13 13





50,000 35,000 85,000 20,000 5,000 25,000 _________ ICC PREMIUM 6SUBTOTAL 625

IF RETURN PREMIUM, MAIL REFUND TO: � INSURED � AGENT � PAYOR. THE ABOVE CRS PREMIUM DISCOUNT ____%�





END 8 May 1, 2005

EXAMPLE 3

INCREASING COVERAGE

� Policy term is December 12, 2005-2006

� Single family dwelling, no basement � Pre-FIRM Building � Building located in Zone C � Present coverage: Building $35,000/ Contents

$10,000 � Endorsement is effective on May 1, 2006, to add

additional coverage of $65,000 on the buildingand $15,000 on the contents for a total of$100,000 building coverage and $25,000contents coverage.

� Premium rates are: Building .64/.14, Contents

.99/.25. � To increase coverage, complete Sections A

and B. Section A is for current coverage.Section B should show the amount of thecoverage increase only.

� $15,000 of the $50,000 coverage to be added on

the building must be calculated in the “Amount”column under Section B, “Increased-DecreasedCoverage Only” (using the applicable rate) toamend the present coverage to the threshold forthe Regular Program basic limits.

� $10,000 of the $15,000 coverage to be added onthe contents must be calculated under the“Amount” column under Section B, “Increased-Decreased Coverage Only” (using the applicablerate) to amend the present coverage to thethreshold for the Regular Program basic limits.

� Add Section A and B premiums to obtain the

New Premium Totals. � Add the New Premium Totals to calculate the

Premium Subtotal. � Add in the ICC Premium. � The Premium Previously Paid is $329 (excluding

Probation Surcharge/Federal Policy Fee) which isthe total current annual premium including ICCpremium.

� Subtract the Premium Previously Paid from the

Premium Total to obtain the Difference (shouldbe additional/return premium).


Time period is May 1, 2006,to December 12, 2006Number of days is 225Pro rata factor is .616

INSURANCECOVERAGE



ONLY

NEWPREMIUMTOTALS

AMOUNT RATE PREMIUM AMOUNT RATE PREMIUMBUILDING BASIC 35,000 .64 224 15,000 .64 96 320

BUILDINGADDITIONAL

50,000 .14 70 70

CONTENTS BASIC 10,000 .99 99 10,000 .99 99 198

CONTENTSADDITIONAL

5,000 .25 13 13





50,000 50,000 100,000 20,000 5,000 25,000 _________ ICC PREMIUM 6SUBTOTAL 607






END 9 May 1, 2005

EXAMPLE 4

INCREASING COVERAGE AFTER A RATE CHANGE

� Policy term is July 15, 2005-2006 � Single family dwelling, Regular Program � One floor, no basement � Current policy limits: Building $30,000 Contents

$8,000 � Building located in an AE Zone, Post-FIRM � Premium rates are: Building 1.08, Contents

1.10 � Post-FIRM construction with a 0 elevation

difference � Endorsement effective date is May 15, 2006 � The coverages being added are $15,000 on the

building and $7,000 on contents for a total of$45,000 building coverage and $15,000 contentscoverage.

� A rate increase takes effect on May 1, 2006. � Rates in effect on the effective date of the policy

are to be used. � In Section A, enter the basic limits and rates for

building and contents in effect at the beginning ofthe policy term.

� In Section B, enter the $15,000 basic buildingamount, and the applicable rate (.98). (Seepage END 1, “Additional Coverage or Increase inAmount of Insurance.” Companies are allowed touse either rates in effect at policy inception orrates in effect at endorsement effective date.)

� In Section B, enter the $7,000 basic contents amount and the applicable rate (1.10).

� Add Sections A and B premiums to obtain

the New Premium Totals. � Add the New Premium Totals to calculate the

Premium Subtotal. � Add in the ICC Premium. � The Premium Previously Paid is $418

(excluding Probation Surcharge/Federal PolicyFee), which is the total current annual premiumincluding ICC premium.


Premium Total to obtain the Difference (should be additional/return premium).


Time period is May 15, 2006,to July 15, 2006Number of days is 61Pro rata factor is .167

INSURANCE COVERAGESECTION A

CURRENT COVERAGESECTION B

+ INCREASED — DECREASED COVERAGE ONLY

NEWPREMIUMTOTALS

AMOUNT RATE PREMIUM AMOUNT RATE PREMIUMBUILDING BASIC 30,000 1.08 324 15,000 1.08 162 486

BUILDINGADDITIONALCONTENTS BASIC 8,000 1.10 88 7,000 1.10 77 165CONTENTSADDITIONAL





45,000 0 45,000 15,000 0 15,000 _________ ICC PREMIUM 6SUBTOTAL 657






END 10 May 1, 2005

EXAMPLE 5

REMOVING CONTENTS

� Policy term is May 20, 2005-2006 � Non-residential structure � Emergency Program � Policy limits: Building $100,000/Contents

$100,000 � Insured purchased a new business location and

moved the contents to the new location while stillretaining the old location as rental property. (Thisexplanation should be recorded in the Reason forChange section of the General ChangeEndorsement form.)

� Present rates for building and contents are

.83/1.62. � Removal date and effective date of change is

January 14, 2006. � Enter the current building and contents

coverages in Section A and the currentrates (.83/1.62).

� Enter the decrease in contents coverage inSection B.

� Add all New Premium Totals to obtain the

Premium Subtotal. � The Premium Previously Paid is $2,450

(excluding Probation Surcharge/Federal PolicyFee), which is the total current premium fromSection A.




Time period is January 14, 2006,to May 20, 2006Number of days is 126Pro rata factor is .345

INSURANCECOVERAGE



ONLY

NEWPREMIUMTOTALS

AMOUNT RATE PREMIUM AMOUNT RATE PREMIUMBUILDING BASIC 100,000 .83 830 0 830

BUILDINGADDITIONAL

CONTENTS BASIC 100,000 1.62 1,620 -100,000 1.62 -1,620 0

CONTENTSADDITIONAL





� � 100,000 � � 0 _________ ICC PREMIUM�


�



(Excludes Probation Surcharge/Federal Policy Fee) 2,450DIFFERENCE - (+/-) -1,620

SIGNATURE OF INSURED AND DATE SIGNATURE OF INSURANCE AGENT/BROKER DATE (MMDDYY) PRO RATA FACTOR .345TOTAL (+/-) -559

END 11 May 1, 2005

EXAMPLE 6

REDUCING BUILDING COVERAGE

� Policy term is September 1, 2005-2006 � Single family dwelling, with basement � Regular Program, Zone B, Post-FIRM � Policy limits: Building $150,000/Contents $0 � A wing of the building was destroyed by fire on

July 1, 2006, and the building was repairedwithout the wing, reducing the value of thedwelling to $100,000. (This explanation shouldbe recorded in the Reason for Change section ofthe General Change Endorsement form.)

� Present rates are: Building .73/.20. � Endorsement effective date is July 1, 2006. � In Section A, enter the basic building amount

($50,000) and the applicable rate (.73). � In Section B, enter the new additional building

amount at the same rate of .20.

� Add Sections A and B to obtain the NewPremium Totals.

� Add the New Premium Totals to obtain the

Premium Subtotal. � The Premium Previously Paid is $571 (excluding

Probation Surcharge/Federal Policy Fee), whichis the total current annual premium including ICCpremium.

� Add ICC Premium. � Subtract the Premium Previously Paid from the



Time period is July 1, 2006,to September 1, 2006Number of days is 62Pro rata factor is .170

INSURANCECOVERAGE



ONLY

NEWPREMIUMTOTALS


BUILDINGADDITIONAL

100,000 .20 200 -50,000 .20 -100 100

CONTENTS BASIC�

CONTENTSADDITIONAL

�





50,000 50,000 100,000 _________ ICC PREMIUM 6SUBTOTAL 471




(Excludes Probation Surcharge/Federal Policy Fee) 571DIFFERENCE - (+/-) -100


END 12 May 1, 2005

EXAMPLE 7

INCREASING DEDUCTIBLE

� Policy term is January 15, 2006-2007 � Single family dwelling � Emergency Program (Pre-FIRM) � Current policy limits: Building $35,000/Contents

$10,000 � Policy deductible: $1,000/$1,000 � Insured requests to increase deductible to

$4,000/$2,000 (.825), effective June 15, 2006.(This explanation should be recorded in theReason for Change section of the GeneralChange Endorsement form.)

� Present rates are: Building: .76, Contents .96. � Enter the current building and contents coverage

in Section A, and enter the applicable rates.

� Add Sections A and B to obtain the NewPremium Totals.

� Add the New Premium Totals to obtain the

Premium Subtotal. � The Premium Previously Paid is $362 (excluding

ICC*, and Probation Surcharge/Federal PolicyFee), which is the total current annual premiumfrom Section A.

� Calculate the Deductible Discount amount and

enter that amount in the block marked Difference. � Prorate the Difference

Time period is June 15, 2006,to January 15, 2007Number of days is 214Pro rata factor is .586

*ICC-N/A in Emergency Program

INSURANCECOVERAGE



ONLY

NEWPREMIUMTOTALS


BUILDINGADDITIONAL

�

CONTENTS BASIC 10,000 .96 96 0 96

CONTENTSADDITIONAL

�



DEDUCT.DISCOUNT/SURCHARGE

-63

BASIC ADDITIONAL TOTAL BASIC ADDITIONAL TOTAL � OTHER: SUBTOTAL 299_________ ICC PREMIUM N/A


�



(Excludes Probation Surcharge/Federal Policy Fee) 362DIFFERENCE - (+/-) -63


END 13 May 1, 2005

END 14 May 1, 2005

GENERAL CHANGE ENDORSEMENT - FEMA.gov · 2012-07-19 · General Change Endorsement and additional...

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Transcript of GENERAL CHANGE ENDORSEMENT - FEMA.gov · 2012-07-19 · General Change Endorsement and additional...