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Last modified
7/12/2021 11:25:22 AM
Creation date
7/12/2021 11:24:05 AM
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Contracts
Company Name
MARK THOMAS
Contract #
A-2018-159-07A
Agency
Public Works
Council Approval Date
6/19/2018
Expiration Date
6/18/2023
Insurance Exp Date
9/15/2021
Destruction Year
2028
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G-300660-A <br />(Ed. 06/08) <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />CHANGES - NOTICE OF CANCELLATION OR MATERIAL CHANGE <br />This endorsement modifies insurance provided under the following: <br />BUSINESS AUTO COVERAGE FORM <br />GARAGE COVERAGE FORM <br />TRUCKERS COVERAGE FORM <br />This endorsement changes the policy effective on the inception date of the policy unless another date is indicated <br />below: <br />Endorsement Effective: 09/15/2020 <br />Policy Number: 6078951371 <br />Named Insured: Mark Thomas & Company, Inc. <br />Countersigned by <br />(Authorized Representative) <br />In the event of cancellation or material change that reduces or restricts the insurance afforded by this Coverage Part, <br />we agree to mail prior written notice of cancellation or material change to: <br />SCHEDULE <br />1. Number of days advance notice: 30 <br />2. Name: City of Santa Ana <br />3. Address: Risk Management Division, 20 Civic Center Plaza, Santa Ana, CA 92701 <br />G-300660-A <br />(Ed. 06/08) <br />57714801 1 11HWeL-1 120-21 Maeter Certi Eieate I Prabhjot t(aar 19/23/2020 2:39:23 PM (PDT) I Page 10 of 11 <br />itiakiner)tDbssron <br />Ref fl & APPROVED BY: <br />Risk Managemen[Analyst <br />
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