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Entry Properties
Last modified
11/20/2025 11:41:10 AM
Creation date
7/5/2023 10:34:04 AM
Metadata
Fields
Template:
Contracts
Company Name
KIMCO STAFFING
Contract #
A-2023-122-04
Agency
Human Resources
Council Approval Date
6/20/2023
Expiration Date
6/30/2026
Insurance Exp Date
12/31/2025
Destruction Year
2031
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POLICY NUMBER: PHPK2599195007 COMMERCIAL AUTO <br /> CA 20 48 02 99 <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> DESIGNATED INSURED <br /> This endorsement modifies insurance provided under the following: <br /> BUSINESS AUTO COVERAGE FORM <br /> GARAGE COVERAGE FORM <br /> MOTOR CARRIER COVERAGE FORM <br /> TRUCKERS COVERAGE FORM <br /> With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- <br /> fied by this endorsement. <br /> This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provi- <br /> sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. <br /> This endorsement changes the policy effective on the inception date of the policy unless another date is indicated <br /> below. <br /> Named Insured: Kimco Staffing Services, Inc. <br /> Endorsement Effective Date: 09/01/2025 <br /> SCHEDULE <br /> Name of Person(s) or Organization(s): <br /> Any person or organization where required by a written contract executed prior to the occurrence of a loss. <br /> Such person or organization is an additional Insured but only for liability arising out of the negligence of the <br /> named insured. <br /> (If no entry appears above, information required to complete this endorsement will be shown in the Declarations <br /> as applicable to the endorsement.) <br /> Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent <br /> that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained <br /> in Section II of the Coverage Form. <br /> CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 <br />
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