Laserfiche WebLink
<br />. <br /> <br />. <br /> <br />MIDTERM CHANGE DOCUMENT <br /> <br />POUCYNO. PHPK029106 <br />PhILADELPHIA INDEMNITY INSURANCE CO I <br /> <br />NAMED INSURED ORANGE COUNTY CONS¡;;RVATION CORPS <br />MAIUNGADDRESS 700 NORTH VALLEY STREET, SUITE AB <br /> <br />ANAHEIM, CA <br /> <br />92801 <br /> <br />POLICY PERIOD: From 07/20/2002 to 07/20/2003 <br />12:01 A.M. Standard Time at your møllng addl'ÐS$ shown aboVe. <br /> <br />at <br /> <br />CHANGE EFFECTIVE <br /> <br />10/16/200.2 <br /> <br />CHANGE # <br /> <br />00003 <br /> <br />DESCRIPTION <br /> <br />IN CONSIDERATION OF NO CHANGE IN PREMIUM, THE POLICY <br />IS AMENDED AS FOLLOWS, <br /> <br />ADDITIONAL INSURED IS ADDED PER ATTACHED FORM CG2026: <br />SANTA ANA WORK CENTER <br />CITY OF SANTA ANA <br />1000 E. SANTA ANA BOULEVARD, SUITE 200 <br />SANTA ANA, CA 92701 <br /> <br />" ..0 d:.Ü AS 10 FORM <br /> <br />P781317 <br /> <br />-j(¡/~/ / 1h¡ <br />. ,If' Sheedy <br />Citv Attorney <br /> <br />Total Annual <br />AddftlonaljReturn Premium $ <br /> <br />~ Æ¡ìl~ <br /> <br />(Authorl2ed Representative) <br /> <br />COUNTERSIGN¡¡;D 1(1/28/2002 <br />(Date) <br /> <br />inswri <br /> <br />£0/20 'd <br /> <br />1910lBBSOB 'ON j(\J~ <br /> <br />'oa ~ IWIlIOW\I 11\1 L£:O¡ 03M 20Qè-90-AOW <br />