HomeMy WebLinkAbout000153 aENDORSEMENT No. 2
Pnpertyg LnbJIN For use with Fidelity Schedule Bonds (Position Form or Name Form) to add and/or deduct
nl nrx:
Employees and to increase and/or decrease the amount of coverage on bonded Employees.
ATTACHED TO AND FORMING PART DATE ENDORSEMENT EXECUTED EFFECTIVE TIME OF ENDORSEMENT EFFECTIVE DATE Of ENDORSEMENT
OF BOND NO.
400 GJ 7043 4/25/84 12:01 AM 2/1/84
ISSUED TO
Weld County
It is agreed that the following amendments are made in the Schedule of the Bond:
NAME FORM ONLY POSITION FORM ONLY
POSITION OF ADDRESS r 1 NUMBER w NEACH TOTAL
NAME OF EMPLOYEE EMPLOYEE WHERE EMPLOYED E AMOUNT OF
AMOUNT P OSI ION COVE RAGE
EACH POSITIJN
_ DEDUCTIONS FROM SCHEDULE:
$ $
Dennis Kohan Vice Chairman
Housing Authority Greeley, Co. 25,000.00
ADDITIONS TO SCHEDULE:
Connie Eastin Housing Authority Commissioner Greeley, Co 25,000.00
Charles E. Erickson Housing Authority Commissioner Greeley Co 25,000.00
Erich Spitzer Vice Chairman Housing Authority Greeley Co 25,000.00
Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, provisions,
agreements or limitations of the above mentioned Bond, other than as above stated.
Accepted: ST. PAUL FIRE AND MARINE INSURANCE COMPANY
By =-2...j2-+"! -GL - —
Denora May Attorney-in-Fact
153
22240 Ed. 7-73 Printed in U.S -- , � / ' C
j'
INSURED �� =A - " ! `
Hello