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Home My WebLink AboutSpecialty National InsuranceSpecialty National Insurance Company A I~emPe~ COMPANY ENDORSEMENT NO. 16 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 03 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 GENERAL LIABILITY section (s) of this policy. Add Form LB25066 (5/99) Additional Insured - By Contract, Agreement or Permit ADD AS ADDITIONAL INSURED AS THEIR INTERESTS MAY APPEAR IN REGARDS TO A PREMISES BEING USED BY POLICE DEPARTMENT AND OWNED BY US ARMY AND INAAP REUSE AUTHORITY US Army & INAAP Reuse Authority and NU Yale Cleaners, ATIMA 6200 Highway 62, Suite 650 Jeffersonville, IN 47130 NO PREMIUM ADJUSTMENT DUE: ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED AUTHORIZED REPRESENTATIVE CATE' Agent: Clark General Insurance Date: 3/21/2003 dc ZC 25166 (8/99) ENDORSEMENT NO. 16 A'CrACHED TO AND ENDORSEMENT EFFECTIVE FORMING A PART OF (Standard Time) INSURED AGENCY AND CODE POLICY NUMBER MO. DAY YR. 12:0'1 NOON A.M. 3XZ12057001 03 12 2003 X CITY OF JEFFERSONVILLE 430034 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -- BY CONTRACT, AGREEMENT OR PERMIT This endorsement modifies insurance provided under the following: GENERAL LIABILITY COVERAGE FORM - EDUCATIONAL INSTITUTION GENERAL LIABILITY COVERAGE FORM - PUBLIC ENTITY SCHEDULE Name of Person or Organization: US Army & INAAP Reuse Authority and NU Yale Cleaners, ATIMA 6200 Highway 62, Suite 650 Jeffersonville, IN 47130 SECTION II - WHO IS AN INSURED is amended to, include as an insured the person(s) or organization(s) shown in the Schedule above when you and such person or organization have agreed in writing in a contract, agreement or permit that such person or organization be added as an additional insured on your policy. Such person or organization is an insured only with respect to ~iability arising out of your operations, "your work", or premises owned or used by you. This insurance does not apply unless the written contract, agreement, or permit is executed prior to the "occurrence" which results in "bodily injury" or "property damage" Under Coverage A, or the offense which results in "personal and advertising injury" under Coverage B. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED AUTHORIZED REPRESENTATIVE 'DATE' LB 25066 (5/99)