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Last modified
3/2/2020 7:55:31 AM
Creation date
1/28/2020 9:17:33 AM
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Contracts
Company Name
CIVITAS
Contract #
N-2020-025
Agency
COMMUNITY DEVELOPMENT
Expiration Date
1/1/2021
Insurance Exp Date
8/6/2020
Destruction Year
2026
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AGENCY CUSTOMER ID: 90000440 <br />LOC I: —" <br />ADDITIONAL REMARKS SCHEDULE Pape of <br />cernrai �ieauola insurance & Financial Services LLC Civitas Advisors, Inc. <br />POI ICY wMaEe <br />UUUUN(r34az _ _ 11102 Corporate Way Ste 140 <br />Onnalre eMacOoe Sacramento, CA 95631 <br />Travelers Casually Insurance Co of Amarica 1011Aa ..... .,,.M__ <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ADORD FORM, <br />nppum par terms ana conditions of the attached -- <br />endorsemenl(s), <br />Pdmary Wording for Auto Liability applies per terms and conditions of the attached <br />endorsement <br />Auto Liability Waiver of Subrogation applies per terms and conditions <br />endorsement. of the attached <br />General Liability Additional Insured applies per terms and conditions of the attached <br />endorsement(s) <br />Primary Wording for General Liability applies per terms and conditions of the attached <br />endorsement. <br />General Liability Waiver of Subrogation applies per terms and conditions of the attached <br />endorsement. <br />Workers Compensation Waiver of Subrogation applies per terms and conditions of the <br />attached endorsement <br />101 <br />& APPROVED <br />IGEM1ENT DIVISION <br />16 2020 <br />The ACORD e0111e end logo are reglatered marks Or ADORD -"w' ^n nettle re9arva <br />Plhaee by DKV on Docameor 11 2010 at 04.20PM <br />
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