HomeMy WebLinkAboutSt. Paul
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2 DELIVERY INVOICE
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Company: ST. PAUL FIRE & MARINE INSURANCE COMPANY
Policy Inception/Effective Date: 01/25/07
Agency Number: 1602462
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U CITY OF JEFFERSONVILLE
R 501 EAST COURT AVENUE
E JEFFERSONVILLE IN 47130
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Transaction Type:
ENDORSEMENT OF POLICY
Transaction number: 002
Processing date: 02/05/07 10: 43
Policy Number: GP09313606
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A ACORDIA OF KY-LOUISVILLE
G STE 50
E 950 BRECKENRIDGE LANE
N LOUISVILLE KY 40207
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Description
Amount
Surtax/
Surcharge
$309.00
* GP09313606 ENDORSEMENT PREMIUM
40724 Ed.12-90 Printed in U.S.A.
Page 1
INSURED COpy
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g POLICY CHANGE ENDORSEMENT
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This endorsement summarizes the changes to
your policy. All other terms of your policy not
affected by these changes remain the same.
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How Your Policy Is Changed
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INLAND MARINE
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FORM 10006 IS AMENDED, PER THE ATTACHED, TO INCREASE THE LIMIT FROM $2,308,83~.
TO $2,425,834 TO MAKE THE FOLLOWING CHANGE:
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ADD 2006 CATERPILLAR LOADER, #2708, VALUE $117,000.
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TOTAL CATASTROPHE LIMIT IS AMENDED TO $2,425,834.
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Premium Change Which Is Due Now
Additional premium $309
Returned Premium
If issued after the date your policy
begins, these spaces must be completed
and our representative must sign below.
Authorized representative
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Policy issued to
CITY OF JEFFERSONVILLE
Endorsernent takes effect
01/25/07
Processing Date: 02/05/07
40704 Ed.5-84 Printed in U.S.A. Endorsement
@St.Paul Fire and Marine Insurance Co.1984 All Rights ReserVed
Policy Number
GP09313606
10:43 002
Page
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CONTRACTOR'S EOUlPMENT PROTECTION
COVERAGE SUMMARY
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This Coverage Summary shows the limit and
extent of your Contractor's Equipment
Protection.
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Coverage Summary
~ indicates applicable.
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Scheduled equipment Limit of coverage
D See schedule attached ~ Schedule on file $ 2,425,834
Unscheduled equipment you own or have in your care that is used
in your business, but no more than $
for anyone item. $
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Unscheduled equipment leased or rented from others that is used
in your business, but no more than $
for anyone item.
$
$ 2,425,834
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Catastrophe limit
Your Rates
Scheduled Equipment
Unscheduled Equipment you own
Unscheduled Equipment you lease or rent from others
Deposit and minimum annual premium
per $100 of value
per $100 of value
per $100 of rentall fees
(included in premium on
Introduction pagel
Your Deductible
$ 2,500
$
$
$
~ All Coverages
D All Coverages Except As Indicated Below
Increased Additional Benefits Coverage
D Employee Tools
increased to:
$
$
$
$
anyone employee
maximum anyone loss
D Rental Expenses
increased to:
anyone day
maximum anyone loss
Name of Insured
CITY OF JEFFERSONVILLE
Policy Number GP09313606 Effective Date 01/25/07
Processing Date 02/05/07 10:43 002
10006 Ed. 11-95 Printed in U.S.A. Coverage Summary
@ St. Paul Fire and Marine Insurance Co. 1995 All Rights Reserved
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