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CORRECTED
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. 01
Date of Issue: 1/14/91
Effective Date of Change: 12:01 a.m. 1/1/91
A. SCHEDULE*
❑ 1. The Named Insured is changed to:
Elf 2. The following Insured(s) is added as a Named Insured:
Robert Schnepf, Dan Soria,Wesley E. Hall, Warren L. Lasell, William
H. Webster, Shirley Rein, Richard Lengel, and Harriet Meeker.
❑ 3. The following Insured(s) is deleted as a Named Insured:
Gene R. Brantner, Richard Keirnes, Carole V. Mack, Paul M. Stoddard,
Ella Mae White, Richard Zambri, Andrew F. Barr, and Richard A. Gurney
❑ 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
$ $ $
Deductible Amount
Coverage Form Deductible Amount or Section 1 Section 2
S S $
Information required to complete this SCHEDULE, if not shown on this Endorsement, will be shown in the
DECLARATIONS.
228
CR 50 01 10 90 Copyright, Insurance Services Office, Inc., 1983, 1989 Page 1 of 2 O
,POIL. lit
emotk r',
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
S $ $
Accepted:
First Named 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
dith A. Thornton, Attorney-in-Fact
Page 2 of 2 Copyright, Insurance Services Office, Inc., 1983, 1989 CR 50 01 10 90 O
WELD COUNTY PUBLIC OFFICIALS
BOND #S12 45 63
SCHEDULE
William H. Webster' County Commissioner 25,000
',Constance L. Harbert ` County Commissioner 25,000
-----George Kennedy✓ County Commissioner 25,000
.."`C. W. Kirby County Commissioner 25,000
Gordon Lacy -- County Commissioner 25,000
Mary Ann Feuerstein ✓ Clerk and Recorder 25,000
Ed Jordan \/ County Sheriff 20,000
-"Warren L. Lasell ✓ County Assessor 6,000
-A. M. Dominguez, Jr. District Attorney 5,000
Ruth Victoria Beyerinck`V Deputy District Attorney $ 5,000
Rebecca Jane Wilson Brunswig✓Deputy District Attorney 5,000
Thomas G. Hanselmann V Deputy District Attorney 5,000
Robert Knepel" Deputy District Attorney 5,000
Michael W. Morrisse{ _- Deputy District Attorney 5,000
',Thomas Quammen ✓ Deputy District Attorney 5,000
"Susan Sanders ;,: Deputy District Attorney 5,000
"-William Everet Starks .-- Deputy District Attorney 5,000
' Kenneth R. Storck , - Deputy District Attorney 5,000
Names Francis Hartmann II ✓ Deputy District Attorney 5,000
'-.Wesley E. Hall/ County Coroner 25,000
"Dan Soria Deputy County Coroner 25,000
\ Robert Schnepf ✓ Deputy County Coroner 25,000
James M. Sheehan '✓ Exec. Director, Housing Authority 25,000
!Richard Lengel Housing Authority Commissioner 25,000
"Bert R. Dieck ✓ Housing Authority Commissioner 25,000
"Shirley Rein ✓ Housing Authority Commissioner 25,000
Harriet Meeker ✓ Housing Authority Commissioner 25,000
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