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Form SC 01 68 10 18 Page 1 of 1 <br />Process Date:07/09/2026 © 2018, The Hartford Policy Expiration Date:07/09/2027 <br />(May include copyrighted material of Insurance Services Office, Inc., with its permission) <br />SPECTRUM POLICY DECLARATIONS (Continued) <br />POLICY NUMBER: 57 SBW CE0JZV <br />SUPPLEMENTAL DECLARATIONS: <br />A service fee of $8.00 is charged for each installment when your premium is paid in installments.The service fee <br />is $5.00 per withdrawal when you select an electronic fund transfer payment plan.The service fee will be added <br />to the premium amount shown on your premium billing statement. <br />Docusign Envelope ID: 9DF92A24-B534-85BA-8088-342315DF1839