Laserfiche WebLink
Policy Number GLO 9298949-10 <br />Endorsement No. 001 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />COMMON POLICY CHANGE ENDORSEMENT <br />Named Insured PDS TECH, INC. Effective Date: 09-01-2010 <br />12:01 A.M., Standard Time <br />Agent Name LOCKTON COMPANIES, LLC Agent No. 37-385-884 <br />This endorsement will not be used to decrease coverages, increase rates or deductibles or alter any terms or <br />conditions of coverage unless at the sole request of the insured. <br />COVERAGE PART INFORMATION — Coverage parts affected by this change as indicated by ® below. <br />❑ Commercial Property <br />® Commercial General Liability <br />❑ Commerical Crime <br />❑ Commercial inland Marine <br />FJ <br />El <br />The following item(s): <br />❑ Insured's Name ❑ insured's Mailing Address <br />❑ Policy Number ❑ Company <br />❑ Effective/Expiration Date ❑ Insured's Legal Status/Business of Insured <br />❑ Payment Plan ❑ Premium Determination <br />❑ Additional Interested Parties ❑ Coverage Forms and Endorsements <br />® Limits/Exposures ❑ Deductibles <br />❑ Covered Property/Location Description ❑ Classification/Class Codes <br />❑ Rates ❑ Underlying Exposure/Insurance <br />is (are) changes to read [See Additional Page(s)] <br />SEE NEXT PAGE <br />1,0 FOR M <br />. <br />Sheedy <br />Atto <br />The above amendments result in a change in the premiums as follows: <br />This premium does not include taxes and surcharges. <br />❑ No changes <br />® To be Adjusted at Audit <br />I Return <br />Tax and Surcharge Changes <br />Additional Return <br />Countersigned By: <br />AUTHORIZED AGENT <br />U-GU-614-A Cw (10/02) <br />