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55A - HARTFORD INSURNACE
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12/17/2019
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55A - HARTFORD INSURNACE
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Last modified
12/12/2019 5:45:00 PM
Creation date
12/12/2019 5:04:33 PM
Metadata
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Human Resources
Item #
55A
Date
12/17/2019
Destruction Year
2024
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INCORPORATION PROVISION <br />The Certificate(s) of Insurance and Rider(s) listed below are attached to, incorporated in and made a part of, The Policy. <br />Certificate(s) of Insurance Rider(s) <br />Form GBD-1100 (10108) (CA) (803893) 1.08 <br />Form GBD-1100 (10/08) (CA) (803893) 2.07 <br />Form GBD-1100 (10/08) (CA) (803893) 3.05 <br />Form GBD-1100 (10/08) (CA) (803893) 4.07 <br />Form GBD-1100 (10/08) (CA) (803893) 5.05 <br />Form GBD-1100 (10/08) (CA) (803893) 6.05 <br />Form GBD-1200 (10/08) EM LTD (CA) (Rev-1) (803893) Form PA-9474 (10/08) EM (CA) <br />7.04 <br />Form GBD-1200 (10/08) EM LTD (CA) (Rev-1) (803893) Form PA-9474 (10/08) EM (CA) <br />8.04 <br />Form GBD-1200 (10/08) EM LTD (CA) (Rev-1) (803893) Form PA-9474 (10/08) EM (CA) <br />9.04 <br />The provisions found in the Certificate(s) of Insurance will address the benefit plan, period of coverage, exclusions, claims <br />and other general policy provisions pertaining to state insurance law requirements. <br />Form GBD-1000 A (10/08) (CA) 10 <br />55A-15 <br />
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