HomeMy WebLinkAbout000243.tiff a iSta0l ENDORSEMENT Noe 11
Prolxerly&Liabtliry For use with Fidelity Schedule Bonds (Position Form or Name Form) to add and/or deduct
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. T W
400 FV 7613 2/11/83 12:01 AM 1/3/83 r
ISSUED TO -
Weld County
z
It is agreed that the following amendments are made in the Schedule of the Bond:
NAME FORM ONLY POSITION FORM ONLY
NUMBER IN EACH TOTAL
POSITION OF ADDRESS 1 I ✓; `.1 POSITION AMOUNT OF
NAME OF EMPLOYEE EMPLOYEE WHERE EMPLOYED P AMOUNT OF COV. COVERAGE !Y
EACH POSITION
DEDUCTIONS FROM SCHEDULE:
IS $
7-7
- C
E
ADDITIONS TO SCHEDULE: C a
Harold L. Andrews County Sheriff Greeley, Co S S 20,000.00
Paul M. Stoddard County Coroner Greeley, Cc 5,000.00
Mary Ann Feuerstein Clerk & Recorder Greeley, Cc 25,000.00
Jacqueline R.Johnson County Commissioner Greeley, Cc 25,000.00
Gene R. Brantner County Commissioner Greeley, Co 25,000.00
Herbert H. Hansen County Assessor Greeley, Co 6,000.00
F,0'2 thr .
Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, pk�O. w�F Ct
agreements or limitations of the above mentioned Bond, other than as above stated. y • ''"" i17, j''
Accepted: ST. PAUL FIRE AND MARINE IINSURANC LOOM
By i I /222.—.-:c fee t.
Denora May Attorney-in-Fact 243
22240 Ed. 7-73 Printed in U.S.A.
INSURED
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