Laserfiche WebLink
POLICY CHANGE DOCUMENT <br />POLICY NO.: PHPK191129 <br />Philadelphia Indemnity Insurance Companyl 18922 J. Smith Lanier & Co. <br />NAMED INSURED BAY AREA DRIVING SCHOOL <br />MAILING ADDRESS 1070 A St <br />Hayward, CA 94541 -4106 <br />POLICY PERIOD: FROM 11/01/2006 TO 11/01/2007 at <br />12:01 A.M. Standard Time at your mailing address shown above. <br />CHANGE EFFECTIVE 03/29/2007 <br />CHANGE # 2 <br />DESCRIPTION <br />In consideration of the premium reflected, the policy is amended as indicated below: <br />Added: <br />CG2010 -Add' I Insured - Owners, Lessees, Or Contractors - Scheduled Person or <br />Organization with respects to Loc #1, 1070 A St Hayward, CA: <br />The City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />Path ID 2240337 <br />Total Annual Total Prorate <br />Additional/Return Premium $ 0.00 Additional/Return Premium $ 0.00 <br />ADDITIONAL ADDITIONAL <br />COUNTERSIGNED BY <br />(Date) (Authorized d entat / <br />Insured Copy Page 1 of 1 <br />