HomeMy WebLinkAbout000227.tiff NAMED INSURED: Weld County Public Officials
POLICY NUMBER: S12 45 63 COMMERCIAL CRIME
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
POLICY CHANGE
Policy Change No. 02
Date of Issue: 8/23/91
Effective Date of Change: 12:01 a . 7/38/91
A. SCHEDULE'
❑ 1. The Named Insured is changed to:
tl 2. The following Insured(s) is added as a Named Insured:
Mary Pat Daviet
'E1 3. The following Insured(s) is deleted as a Named Insured:
Michael Morrissey
O 4. The Mailing Address is changed to:
❑ 5. The Policy Period is: extended to or reduced to
❑ 6. The following Coverage Form(s) is:
❑Added to the Policy
❑ Deleted from the Policy
O Changed as respects the Limit(s) of Insurance and/or Deductible Amount(s)
Limit of Insurance
Coverage Form Limit of Insurance or Section 1 Section 2
S i i
Deductible Amount
Coverage Form Deductible Amount or Section 1 Section 2
$ S $
Information required to complete this SCHEDULE, if not shown on this Endorsement, will be shown in the
DECLARATIONS.
227
CR 50 01 10 90 Copyright, Insurance Services Office, Inc., 1983, 1989 Page 1 Of 2 0
•
O 7. The following Endorsement(s) is:
❑Added to the Policy
❑Deleted from the Policy
❑Changed as respects the Limit(s) of Insurance
Limit of Insurance
Endorsement Limit of Insurance or Section 1 Section 2
/1
S $ $
Accepted:
it amed Insured
Title
B. PROVISIONS (1) On or after the Effective Date of
1. Application of changes affected by this Change; and also
Endorsement. (2) Before the Effective Date of Change if
a. Addition of a Deductible or Increase in discovered after one year from that
Deductible Amount: This change applies date.
to loss resulting from acts committed or c. All Changes Other Than in a. and b.
events occurring at any time, whether be- Above: This change applies to loss result-
fore or after the Effective Date of Change. ing from acts committed or events occur-
b. Deletion or Restriction (other than in a. ring on or after the Effective Date or
above) of any Coverage or Decrease in Change.
any Limit of Insurance: This change ap- 2. No Limit of Insurance during any period will
plies to loss resulting from acts committed be cumulative with any other amount appli-
or events occurring. cable to the same coverage during any other
period.
Employers Mutual Casualty Company
qiica.-iticth A. Thornton, Attorney-in-Fact
Page 2 of 2 Copyright, Insurance Services Office, Inc., 1983, 1989 CR 50 01 10 90 ❑
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