HomeMy WebLinkAboutVehcilesSpecialty National Insurance Company
A I~m~=~ COMPANY
ENDORSEMENT NO. 14
ATTACHED TO AND ENDORSEMENT EFFECTIVE
FORMING A PART OF (Standard Time) iNSURED AGENCY AND CODE
POLICY NUMBER MO. DAY YR. 12:01 NOON
A.M.
3XZ12057001 02 12 2003 X CITY OF JEFFERSONVILLE 430034
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
In consideration for the premium charged it is hereby understood and agreed the following change (s) are made to the
AUTOMOBILE section (s) of this policy.
2000 Dodge Van
3450
$25,000
$250 Comprehensive/S500 Collision deductibles applicable.
NO PREMIUM ADJUSTMENT DUE:
ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED
AUTHORIZED REPRESENTATIVE
DATE
Agent: Clark General Insurance
Date: 3/17/2003
dc
ZC 25166 (8/99)
Specialty National Insurance Company
a COMPANY
ENDORSEMENT NO. 15
ATTACHED TO AND ENDORSEMENT EFFECTIVE
FORMING A PART OF (Standard Time) INSURED AGENCY AND CODE
POLICY NUMBER MO. DAY YR. '12:01 NOON
A.M.
3XZ'12057001 02 26 2003 X CITY OF JEFFERSONVILLE 430034
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
In consideration for the premium charged it is hereby understood and agreed the folloWing change (s) are made to the
AUTOMOBILE section (s) of this policy.
2003 Hyundai
1759
$18,000
$250 Comprehensive/S500 Collision deductibles applicable.
DELETE:
1999 Ch~sler Cirrus
7949
$18,500
NO PREMIUM ADJUSTMENT DUE:
ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED
AUTHORIZED REPRESENTATIVE
DATE
Agent: Clark General Insurance
Date: 3/17/2003
dc
ZC 25166 (8/99)