HomeMy WebLinkAbout20051275.tiff r^°Ctl1/4 Page 1 of 3
W
�1a�7r Western Surety Company
CHANGE NOTICE
WESTERN SURETY COMPANY is hereby requested to make the following additions to and-or deductions
from the Schedule of Employees attorhed to Bond No. 158425466 issued to
County of Weld Address Greeley, CO
subject to all the terms,limitations and conditions therein set forth.
This acceptance notice is issued with the distinct understanding that the liability of WESTERN SURETY
COMPANY shall under no circumstances be cumulative,and shall net exceed the amount of bond in eiiect as to any
employee or employees when the dishonest act of the employees shall have been committed, and shall in no event
exceed the nuximum amount at any time specified as to such employee or employees.
ADDITIONS
DATE OF ITEM PREMIUM
ADDITION NO. NAME POSITION LOCATION AMOUNT CHARGE
02-02-05 50. Philip Clark Assistant District s 5,000.00 a NAP
Attorney
02-02-05 51. Steve Bastard Chief lkpzity District 5,000.00 NAP
Attorney
02-02-05 52. Jennifer Clegem Deprty District 5,000.00 NAP
Attorney
. 02-02-05 53. C. l3+at Kelly Deputy District 5,000.00 NAP
Attorney
DEDUCTIONS
DATE OF ITEM PREMIUM
NAME POSITION LOCATION AMOUNT DEDUCTION NO. CRAWL
02-02-05 10. A. M. tbrdnguez, Jr. District Attorney s •
7.5,O00i 00 a 4.94 W
02-02-05 U. Moms 4x+mm Assistant District. 5,000.00 4.94 EP
Attorney
02-02-05 14. Patrice Engel Dep.ity District 5,000.00 4.94 FP
Atton2sy
02-02-05 19. Fttert KDepel Ia puty District 5,000.00 4.94 AP
Attorney
Dated day of February 2005 .
4IrSErYN-we frt Count t f Weld /
jia, �ARF9i Sun :maBy . /Y' . /. / .14V
43\ s V 11
N • be signed by WESTE : N ' URET COMPANY
the partnership,by
a mew • •if a corporation, By �...
by a duly authorized officer. PAUL T.BEUFLAT,SENIOR 4=PEESIDENM
Fam 218-11.2002
'!!rnetin _ �0s 2005-1275
Page 2 of 3
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Western Surety Company
CHANGE NOTICE
WESTERN SURETY COMPANY is hereby requested to make the following additions to and-or deductions
from the Schedule of Employees attached to Bond No. 158425466 ,issued to
County of Weld Address Greeley, CO
subject to all the terms,limitations and conditions therein set forth.
This acceptance notice is issued with the distinct understanding that the liability of WESTERN SURETY
COMPANY shall under no circumstances be cumulative, and shall not exceed the amount of bond in effect as to any
employee or employees when the dishonest act of the employees shall have been committed, and shall in no event
exceed the maximum amount at any time specified as to such employee or employees. .
ADDITIONS
DATE OF ITEM PREMIUM
ADDITION 100. NAME POSITION LOCATION AMOUNT
CHARGE
•
02-02-05 54. Matt Maillaro Deputy District $ 5,000.00 *NAP
Attorney
02-02-05 55. Michael Rourke Chief Deputy 5,000.00 NAP
District Attorney
02-02-05 56. Jamie Tholeon Deputy District 5,000.00 .
Attorney
DEDUCTIONS
DATE OF ITEM PREMIUM
DEDUCTION NO. NAME POSITION LOCATION AMOUNT CHARGE
02-02-05 24. Dale Pugh Deputy District $ 5,000.0O $ 4,94 RP
Attorney
02-02-05 26. Kenneth Storck Deputy District 5,000.00 4.95 RP
Attorney
02-02-05 27. Chris Vogt Deputy District 5,000.00 4.95 PP
Attorney
02-02-05 36. Stephanie Deputy District 5,000.00 4.95 RP
Frango1ia Attorney •
Dated Znd day of February , 2005 ,
Cws�, Co of W
`aj o% qj�q-
W 1�.1 } By TIMM
NV. S�p4''* � �� WESTE N URET COMPANY
the sign
partnership,by
-a me •if a corporation, By
by a duly authorized officer. PAUL T.ERUFIAT.SENIOR PRI3)ENT •
•
Fain 21611-2002
Page 3 of 3
OD%
\A€stern Surety Company
CHANGE NOTICE
WESTERN SURETY COMPANY is hereby requested to make the following additions to and-or deductions
from the Schedule of Employees attached to Bond No. 158425466 ,issued to
County of Weld Address Greeley, CO
subject to all the terms,limitations and conditions therein set forth.
This acceptance notice is issued with the distinct understanding that the liability of WESTERN SURETY
COMPANY shall under no circumstances be cumulative, and shall not exceed the amount of bond in effect as to any
employee or employees when the dishonest act of the employees shall have been committed, and shall in no event
exceed the maximum amount at any time specified as to such employee or employees.
ADDITIONS
DATE OF ITEM PREMIUM
ADDITION NO. NAME POSITION LOCATION AMOUNT CE
$ $
DEDUCTIONS
DATE OF unt PREMIUM
DEDUCTION NO. NAME POSITION LOCATION AMOUNT CHARGE
02-D2-05 4D. U,tcbaela Rinker Canners Investigator *25,000.00 *4.95 IP
Dated day of February 2005
/6 C-TX Count f Weld
ter/antqt
A'f``y!WC, § By
3t• I,S�AvrZi
* ! ffi
N t��gned� WEST* N URET COMPANY
the partnership,by
a mem if a aaparation By
by a duly authorized officer. PAUL T.BEUFIAT,SENIOR PaS4IDBNT
tam 21611-]002
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