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d ENDORSEMENT 13 D �' r
EStr�UI F,`<.
PropeM&Liahillry For use with Fidelity Schedule Bonds (Position Form or Name F ) to $$,,dd and/or deduct
Imurnnce �
Employees and to increase and/or decrease the amount of cover on bWt0 €imBlgyRga- '(1
ATTACHED TO AND FORMING PART DATE ENDORSEMENT EXECUTED EFFECTIVE TIME OF ENDORSEMENT EfFECTIVi DATE OF P1 ORSEME
OF BOND NO.
400 FV 7613 12/15/83 12:01 AM 12/6/83
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
NUMBER IN EACH TOTAL
POSITION OF ADDRESS POSITION
NAME OF EMPLOYEE EMPLOYEE WHERE EMPLOYED AMOUNT OF
1 AMOUNT OF COV. COVERAGE
I EACH POSITION
1
DEDUCTIONS FROM SCHEDULE:
$
Elizabeth Strobel Deputy District Attorney Greeley, 5,000.00
Co
ADDITIONS TO SCHEDULE:
David J. Plasters Deputy District Attorney Greeley,Co 5,000.00
David Goldberg Deputy District Attorney Greeley,Co 5,000.00
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 XL rL �/ L
Denora May Attorney-in-Fact 245
22240 Ed. 7-73 Printed in U.S.A.
INSURED
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