HomeMy WebLinkAbout581986 ANDERSON CONSTRUCTION CO INC - INSURANCE CERTIFICATE (5)®Allstate.
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POLICY NUMBER: 648735184
COMMERCIAL AUTO
CA20481013
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED FOR
COVERED AUTOS LIABILITY COVERAGE
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by this endorsement.
This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage
under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage
provided in the Coverage Forma
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated
below.
Named Insured: ANDERSON CONSTRUCTION COMPANY
Endorsement Effective Date: 0 5 -17 - 2 017
SCHEDULE
Name Of Person(s) Or Organization(s):
CITY OF FORT COLLINS
C/O PURCHASING DIVISION
PO BOX 580
FORT COLLINS, CO USA 805220580
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Each person or organization shown in the Schedule is
an "insured" for Covered Autos Liability Coverage, but
only to the extent that person or organization qualifies
as an "insured" under the Who Is An Insured
provision contained in Paragraph A.1. of Section II —
Covered Autos Liability Coverage in the Business
Auto and Motor Carrier Coverage Forms and
Paragraph D.2. of Section I — Covered Autos
Coverages of the Auto Dealers Coverage Form.
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BU114R-3 CA 20 48 10 13
C Insurance Services Office, Inc., 2011
Additional Insured Copy
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