HomeMy WebLinkAboutR T INSTALLATIONS - INSURANCE CERTIFICATE (7)THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Policy Number: 04594-74-39
POLICY CHANGES
Effective Date of Change: 07/09/04
Change Endorsement No.: 001
Named Insured: R T INSTALLATIONS INC
1649 E 83RD DR
DENVER CO 80229-5509
The following item(s):
Expiration Date: 04/03/05
Agent: 07-17-321
E4277
1 st Edition
Insured's Name
Insured's Mailing Address
Policy Number
Company
Effective / Expiration Date
Insured's Legal Status / Business of Insured
Payment Plan
Premium Determination
Additional Interested Parties
Coverage Forms and Endorsements
Limits / Exposures
Deductibles
Covered Property / Location Description
Classification / Class Coda
Rates
Underlying Insurance
is (are) changed to read (See Additional Page(s)):
The above amendments result in a change in the premium as follows:
No Changes I I To Be Adjusted At Audit I Additional Premium I Return Premium
Authorized Representative Signature:
FARMERS
914277 1ST EDI110N 7-02 Induda ("igh.d WAWA Immaw Smdas 0%, Inc, w0h h pmdsdoL E4277101 PAGE 1 OF 2
E4277-Ml
Policy Changes Endorsement Description
REINSTATE WITH LAPSE
ADDITIONAL INSUREDS NOTIFIED
CITY OF FT COLLINS
PO BOX 580
FT COLLINS CO 80522
Removal If Covered Property is removed to a new location that is described on this Policy Change,
Permit you may extend this insurance to include that Covered Property at each location during
the removal. Coverage at each location will apply in the proportion that the value at each
location bears to the value of all Covered Property being removed. This permit applies up
to 10 days after the effective date of this Policy Change: after that, this insurance does not
apply at the previous location.
9142R 1ST EDMON 7-02 Irdudes (Wighed Mebrmt Insmmm Seift ONim, Inc, •hh 1s pernWm. E4277102 PAGE 2 OF 2
E4277401