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Last modified
5/18/2023 4:12:50 PM
Creation date
3/1/2021 10:55:54 AM
Metadata
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Template:
Contracts
Company Name
FEHR & PEERS
Contract #
A-2020-241-19
Agency
Planning & Building
Council Approval Date
12/1/2020
Expiration Date
11/30/2023
Destruction Year
2028
Notes
For Insurance Exp. Date see Notice of Compliance
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This Policy consists of the Declarations, Coverage Forms, Common Policy Conditions and any other Forms and Endorsements <br />issued to be a part of the Policy. This insurance is provided by RLI insurance Company. <br />RLI Insurance Company RLI <br />e <br />Peoria, Illinois <br />RLIPack BUSINESSOWNERS DECLARATIONS <br />Policy Number:PSB0006683 [] New [X] Renewal of PSB0006683 <br />Named Insured and Mailing Address: Agent/Broker: 68072 <br />Fehr & Peers IOA Insurance Services (68072) <br />3875 Hopyard Rd, Ste 200 <br />100 Pringle Avenue, Suite 600 Pleasanton, CA 94588 <br />Walnut Creek, CA 94596 <br />Policy Period: From 12-06-2021 To 12-06-2022 <br />12:01 A.M. Standard Time at your mailing address shown above. <br />Legal Entity: Corporation <br />LOCATION SCHEDULE <br />Described Premises Address: <br />Refer to RLI Pack Schedule of Locations, PPB 501 <br />Refer to RLI Pack Businessowners Supplemental Declarations - Building and Locations Coverages, PPB 111, for <br />coverage details. <br />Billing Plan: Direct Bill, Full Pay <br />Audit Frequency: Waived <br />Insurance Provided: In return for the payment of the premium and subject to all of the terms of this policy, we agree <br />with you to provide insurance as stated in this policy. <br />Estimated Premium, excluding Terrorism: $22,810 <br />Terrorism Charge: $610 <br />Applicable Taxes, Fees, and Surcharges: $5.64 <br />TOTAL ESTIMATED PREMIUM, TAXES, FEES, AND SURCHARGES: $23,425.64 <br />Countersigned By Authorized Representative Date: <br />12-07-2021 <br />PPB 100 12 10 <br />RAMuagmadDlMsian <br />E <br />REVIEWED & APPROVED BY: <br />e Aeevaa <br />'�--'Risk Management Specialist <br />
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