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Company: ST. PAUL FIRE & MARINE INSURANCE COMPANY
Policy Inception/Effective Date: 01/25/07
Agency Number: 1602462
CITY OF JEFFERSONVILLE
501 EAST COURT AVENUE
JEFFERSONVILLE IN 47130
Transaction Type:
ENDORSEMENT OF POLICY
Transaction number: 002
Processing date: 02/05/07
Policy Number: GP09313606
10:43
ACaRDIA OF KY-LOUISVILLE
STE 50
950 BRECKENRIDGE LANE
LOUISVILLE KY 40207
Policy
Number
Description
Amount
Surtax/
Surcharge
$309.00
* GP09313606 ENDORSEMENT PREMIUM
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40724 Ed.12-90 Printed in U.S.A.
Page 1
INSURED COpy
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~ POUCY CHANGE ENDORSEMENT
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 $2,308,834
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.
Policy issued to
CITY OF JEFFERSONVILLE
Authorized representative
Endorsement takes effect
01/25/07
Processing Date: 02/05/07
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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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COi\lTRACTOR'S EOUIPMENT 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
[gJ indicates applicable.
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Scheduled equipment Limit of coverage
D See schedule attached [gJ 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
per $100 of value
per $100 of value
per $100 of rental fees
(included in premium on
Introduction page)
Unscheduled Equipment you own
Unscheduled Equipment you lease or rent from others
Deposit and minimum annual premium
Your Deductible
$ 2,500
$
$
$
[gJ 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
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Policy Number GP09313606 Effective Date 01/25/07
Processing Date 02/05/07 10: 43 002
10006 Ed. 11-95 Printe.d in U.S.A. Coverage Summary
@ St. Paul Fire and Marine Insurance Co. 1995 All Rights Reserved
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