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MENDIOLA, CRISSELLE
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MENDIOLA, CRISSELLE
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Last modified
3/14/2024 10:18:06 AM
Creation date
3/14/2024 10:16:51 AM
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Contracts
Company Name
MENDIOLA, CRISSELLE
Contract #
N-2024-084
Agency
Community Development
Expiration Date
4/30/2024
Insurance Exp Date
1/1/2025
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />POLICY CHANGES <br />Policy Change <br />Number 05 <br />POLICY NUMBER <br />POLICY CHANGES <br />COMPANY <br />EFFECTIVE <br />NXTQF9PPV3-01-GL <br />03/06/2024 <br />State National Insurance Company, Inc. <br />NAMED INSURED <br />AUTHORIZED REPRESENTATIVE <br />Crisselle Mendiola <br />1214 Saint Anne PI <br />Santa Ana, CA 92707 <br />Ann Ryan <br />COVERAGE PARTS AFFECTED <br />Commercial General Liability Coverage Part <br />CHANGES <br />SEE ATTACHED SCHEDULE <br />Return Total $0.00 <br />Authorized Representative Signature <br />IL 12 01 11 85 Copyright, Insurance Services Office, Inc., 1983 <br />Copyright, ISO Commercial Risk Services, Inc., 1983 <br />e <br />yryj <br />RiekMutogemmtDl sL= <br />REM1k APPROVED BY: <br />Lam• <br />Ruk Management Spedalis[ <br />
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