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D. WOOLLEY & ASSOCIATES
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D. WOOLLEY & ASSOCIATES
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Last modified
3/27/2020 8:47:00 AM
Creation date
8/16/2019 10:12:40 AM
Metadata
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Template:
Contracts
Company Name
D. WOOLLEY & ASSOCIATES
Contract #
A-2017-161-01
Agency
PUBLIC WORKS
Council Approval Date
7/5/2017
Expiration Date
7/5/2020
Insurance Exp Date
1/1/1900
Destruction Year
2025
Notes
A-2017-161
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POLICYNUMBER: PSA0001203 <br />COMMERCIAL AUTO <br />CA 20 48 10 13 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />DESIGNATED INSURED FOR <br />COVERED AUTOS LIABILITY COVERAGE <br />This endorsement modifies insurance provided under the following: <br />AUTO DEALERS COVERAGE FORM <br />BUSINESS AUTO COVERAGE FORM <br />MOTOR CARRIER COVERAGE FORM <br />With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless <br />modified by this endorsement. <br />This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage <br />under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage <br />provided in the Coverage Form. <br />This endorsement changes the policy effective on the inception date of the policy unless another date is indicated <br />below. <br />Named Insured: D. Woolley&Associates, Inc.; <br />Harbinger Analytics Group <br />Endorsement Effective Date: 2/11/2019 <br />SCHEDULE <br />Name Of Person(s) Or Organization(s): <br />City of Santa Ana, their employees, <br />officers and directors <br />Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br />Each person or organization shown in the Schedule is <br />an "insured" for Covered Autos Liability Coverage, but <br />only to the extent that person or organization qualifies <br />as an "insured" under the Who Is An Insured <br />provision contained in Paragraph A.1. of Section II — <br />Covered Autos Liability Coverage in the Business <br />Auto and Motor Carrier Coverage Forms and <br />Paragraph D.2. of Section I — Covered Autos <br />Coverages of the Auto Dealers Coverage Form. <br />CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 <br />50140704 12/19-20 GL/AUTO/EXCESS/WC/PL I Donna Esquivel 17/24/2019 30:10:36 A (PDT) I Page 3 of 5 <br />
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