HomeMy WebLinkAbout2003 Bonds WESTFIELD INSURANCE COMPANY
WESTFIELD NATIONAL INSURANCE COMPANY
OHIO FARMERS INSURANCE COMPANY
WESTFIELD CENTER, OHIO 44251-5001
Schedule Effective 1-1-03 to be attached to Bond No. 584 1313 issued in favor of STATE OF INDIANA FOR USE AND
BENEFIT OF CLARK COUNTY SHERIFF'S DEPARTMENT.
The agreed premium for the above bond is accepted upon the following terms and conditions: That this schedule supersedes all prior schedules attached to the
bond, and only those individuals whose names and positions (if the bond is a name schedule) or positions only (if the bond is a position schedule) appear on this
schedule airs covered under the bond on and after the first day of the current premium period; that the coverage on each individual is continuous from its
inception to its termination, and the coverage for separate periods shall not be cumulative; that if the coverage on any individual for separate periods be for
different amounts, the maximum liability of the Company for all defaults of that individual shall be governed by the provisions of the bond, and shall in no event
exceed the largest amount of coverage in force during any period within which defaults shall have occurred, nor shall the coverage for one period be available
for defaults occurring within any other period.
Form __ Rate __ Agency DIVERSIFIED INSURANCE GR¢
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I'FIELD INSURANCE COMPANY
FFIELD NATIONAL INSURANCE COMPANY
~ORO~ A~or~-in-Fact
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Notice Acc. Date of (Insert Name and Position if Name Schedule;
NO. NO. Add, Position only if Position Schedule) LOCATION AMOUNT PREM. Date of Dad. Ret,
NAME POSITION Pram.
1. MIKE COCHRAN RESERVE CLARK CNTY, IN $5,000 $25.00
OFFICER
2. JOHN CORTIE
3. STEVE
CUNNINGHAM
4. RENAE
HARRISON
5. DANNY
KELLAMS
6. RENO KITTS
7. DENNIS
LANGFORD
8. TOM LANTRIP
9. JAY MARR
10. BILL MAY
BD 5116 OFWVVN (03-0'~)
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Page 2
WESTFIELD INSURANCE CO.
WESTFIELD NATIONAL INSURANCE CO.
OHIO FARMERS INSURANCE CO.
Westfield Center, Ohio 44251
SHEET NO. 2.
Nat[c ACC, Date of insert Name and Position if Name Schedule;
e NO. Add. Position only if Position Schedule) LOCATION AMOUNT PREM, Date of Ret.
No, NAME POSITION Dad. Pram.
JOHN RESERVE CLARK CNTY
11 MCKIM OFFICER IN $5,000 $25.00
BOB MILLER ,,
12.
ROB PHILPOT
13.
TIM
14. ROBERTSON
GENE
15. SPENSER
IASON
16. STRICKER
DAN TENNY
17.
DARIN
18. VAUGHN
BILL WATSON
19.
ED
20. SCHWARTZ
TOM
21. O'NEIL SR
BRIAN JONES
22.
NICHOLAS
23. HEDGE
BD 5116A OFWWN (03-01 )