HomeMy WebLinkAboutAMERICAN STOP LOS - CONTRACT - RFP - P692 BENEFITSApplication is Hereby Made to
ULICO CASUALTY COMPANY
(The Company)
Home Office 111 Massachusetts Avenue N W
Washington D C 20001
By CITY OF FORT COLLINS
Whose address is 39&J ALAI evFr�TtrT ern�a �a J`%C�
FORT COLLINS, CO 80522-0580
For Contract Number D-9565
This Contract is hereby approved and all of its terms and provisions are accepted
This application is executed in duplicate one copy to be attached to the Contract and the other to be
returned to the Company
Dated at this o2 day of )u L
►�
EXECUTED FOR THE INSURED
CITY OF FORT COLLINS
B
Title
Return a copy of the signed Application to
Union Labor Life Group Contracts
111 Massachusetts Avenue, N W
Washington, D C 20001
300 UCA