Laserfiche WebLink
SIGNATURES <br />Named Insured <br />Endorsement Number <br />Benevate, Inc <br />Policy Symbol <br />Policy Number <br />Policy Period <br />Effective Date of Endorsement <br />G72503910001 <br />01/18/2021 to 01/18/2022 <br />01/18/2021 <br />Issued By (Name of Insurance Company) <br />Illinois Union Insurance Company <br />Insert the policy number. The remainder of the Information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. <br />THE ONLY SIGNATURES APPLICABLE TO THIS POLICY ARE THOSE REPRESENTING THE COMPANY NAMED ON <br />THE FIRST PAGE OF THE DECLARATIONS. <br />By signing and delivering the policy to you, we state that it is a valid contract. <br />ILLINOIS UNION INSURANCE COMPANY (A stock company) <br />525 W. Monroe Street, Suite 400, Chicago, Illinois 60661 <br />WESTCHESTER SURPLUS LINES INSURANCE COMPANY (A stock company) <br />Royal Centre Two, 11575 Great Oaks Way, Suite 200, Alpharetta, GA 30022 <br />REBECCA L.COLLINS, Secretary <br />LD-5S23i (03/14) <br />ull <br />.�u ��UjjltrQ�" �. .„,�,rnnIQIQUI�II <br />Authorized Representative <br />Chubb. Insured' <br />Nwn WManagenentDielslon <br />RoAEWED&APPROVED BY., <br />Risk Management Analyst <br />