HomeMy WebLinkAbout490347 M & E PAINTING LLC - INSURANCE CERTIFICATETHIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ R CAREFULLY.
Policy Number: 60478-70-14
POLICY CHANGES
Effective Date of Change: 03/03/14
Change Endorsement No.: 004
Named Insured: M & E PAINTING LLC 11
540 W 66TH AVE B1
LOVELAND CO 80538-4669
The following item(s):
Expiration Date: 01/01/15
Agent: 07-08-348
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
X
Additional Interested Parties
Coverage Forms and Endorsements
Limits / Exposures
Deductibles
Covered Property / Location Description
Classification / Class Codes
Rates
Underlying Insurance
is (are) changed to read (See Additional Page(s)):
The above amendments result in a change in the premium as follows:
X I No Changes I To Be Adjusted At Audit I Additional Premium Return Premium
Authorized Representative Signature:
FARMERS
INSURANCE
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Policy Changes Endorsement Description
ADD ADDITIONAL INTEREST
ADDITIONAL INSURED-BP04500197
OWNERS, LESSEES OR CONTRACTORS
CITY OF FT COLLINS
215 N MASON
FT COLLINS, CO 80524
LOCATION: 540 W 66TH AVE BI
LOVELAND, CO 80538
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.
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