Laserfiche WebLink
Oot O1 03 ~l:S4p Pictome~r~ International SBS-4BB-DOgB <br /> <br />· "OCt,' I. 2'ri03 )1:33A~ Paris Kirwan Associ~tss No.7i56 P. 2 <br /> <br />OneTow~Squ~m. H&nlord. Connec~lt 061M <br /> <br /> NamMJ Insured: <br /> <br /> Policy Number: <br />Policy Effe=flve DaM: <br />Policy Expiration Data: <br />Issue Date: <br /> Premium $ <br /> <br /> CHANGE. ENDORSEMENT <br />~CTOMETR~ ZlfT]~U~A~'ZCe(AL co~P <br /> <br />Z-680*938H~lIA-COF-02 <br />10-03-02 <br /> <br />0~-30-03 <br /> <br />Effective from 06-02 -03 atUte time of day the poJJcy becomes effective. <br />THIS INSURANCE IS AMENDED AS FOLLOWS: <br /> <br />~PO~ At~/0a RA~'I~ 9ROCEDOP. E. <br /> <br />Bf/$r'~w*?*~l~OU9 COV~A,%G~ ,~qB ADD~) AS P'OLLOW5: <br />PLUM. HO. B~DG. NO. DESCRTp'~'rO~q <br /> <br />ol 01 <br /> <br />A/~)L /:RBD ~AN't'A ~ <br /> <br />T~E FOLL0W'rNG FOI~S OR EI~DORSB~T$ *rS/A~,~ ZNCLUD~D WZ~ 'XHI8 ~. <br />0N TB~ POLZCY. <br /> <br />C~ F2 77 06 03 <br /> <br />APPg0VED. AIS TO FORM <br /> <br />Mic[~a"el Vigliotta (J <br />Deputy City Attorney <br /> <br />NAME AND ADDRESS OF AGENT OR BROKER <br /> <br />~O ]aOX 40,~20 <br />Itocn 9'1'?,R t~' <br /> <br />14604 <br /> <br />Countemign~ <br /> <br /> Authoriz~l Representative <br /> <br />DATE <br /> <br />ILT0070987 (Page01 of 01) Office* ROCHESTER <br /> <br /> <br />