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HomeMy WebLinkAboutSt Paul change endorsement (2)COPY POLICY.CHANGE ENDORSEMENT This endorsement summarizes the changes to your policy. All other terms of your policy not affected by these changes remain the same. ~StPaul How Your Policy Is Changed Inland Marine Form 42038,2-83 "Protection For Miscellaneous Property" is amended per the attached. Equipment Added: 2001 Case Turbo Loader valued at $57,000 Premium Change Which is Due Now Additional premium $224.00 If issued after the date your policy begins, these spaces must be completed and our representative must si9n below. Returned Premium Policy issuedto CITY OF JEFFERSONVILLE Authorized representative Endorsement takes effect 11/28/00 Processing Date: 02/26/01 40704 Ed.5-84 Printed in U.S.A. Endorsement ©St. Paul Fire and Marine Insurance Co. 1984 All Rights Reserved Policy Number GP06600801 15:42 008 Page 1 WHO WE'LL PAY FOR LOSS This endorsement changes your: Protection For Miscellaneous Equipment COPY -- ~IP~ul How Your Coverage Is Changed We'll adjust any loss with you. However, our payments for property loss will be made to you and the person or organization shown below based on the interest each of you has in the covered prop- erty. Person or organization Banc One Leasing Corporation 1111Polaria Parkway, Ste A-3 Columbus, OH 43240 Description of property 2001 Case Turbo Loader Covered perils Limit of coverage All $57,000 Other Terms All other terms of your policy remain the same. Name of Insured CITY OF JEFFERSONVILLE Policy Number GP06600~O1 Effective Date 11/28/00 Processing Date 02/26/01 15:42 008 42013 Ed.6-82 Printed in U.S,A, Endorsement ©St. Paul Fire and Marine Insurance Co.1982 All Rights Reserved Page 1 of 1