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GARCIA, CLAUDIA
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Last modified
6/10/2025 3:00:03 PM
Creation date
6/10/2025 2:59:41 PM
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Contracts
Company Name
GARCIA, CLAUDIA
Contract #
N-2025-147
Agency
Parks, Recreation, & Community Services
Expiration Date
5/31/2027
Insurance Exp Date
5/27/2026
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Policy Number: S0220GLD0000100- <br /> CPT202649 <br /> Effective Date of Change: 05/27/2025 <br /> BUSINESSPRO POLICY CHANGES <br /> NAMED INSURED AND ADDRESS: POLICY PERIOD: <br /> Claudia Garcia 12:01 A.M. STANDARD TIME AT THE ADDRESS OF <br /> 360 E 1 St St THE NAMED INSURED SHOWN AT LEFT. <br /> 406 <br /> Tustin, CA 92780 FROM: 05/27/2025 TO: 05/27/2026 <br /> THIS ENDORSEMENT CHANGES BROKER NAME AND ADDRESS: <br /> THE POLICY. Veracity Insurance Solutions, LLC. <br /> 260 South 2500 West, Suite 303 <br /> PLEASE READ IT CAREFULLY, Pleasant Grove, Utah 84062 <br /> INSURANCE IS AFFORDED BY THE COMPANY INDICATED BELOW: <br /> (X)Accelerant Specialty Insurance Company <br /> In consideration of the additional premium of$10.00 plus a BHTA Fee of$10.00,for a total of <br /> $20.00, it is hereby understood and agreed that the following form has been added to the policy <br /> mentioned above: <br /> ❑Additional Insured—Vendors CG2015(Ed. 04 13)with primary and noncontributory wording <br /> 0 Additional Insured—Designated Person or Organization CG 20 26(Ed. 04113)with primary and <br /> noncontributory wording <br /> ❑ Primary and Noncontributory—Other Insurance Condition CG 20 01 (Ed.04 13) <br /> 0 Waiver of Transfer of Rights of Recovery Against Others to Us CG 24 04(Ed.05 09) <br /> ❑ Trailer Endorsement—Amendment to Exclusion-Aircraft,Auto or Watercraft CG 88 02(Ed. 11 85) <br /> ❑ Increase Inland Marine Limits to$(maximum payout for any one article)1$(annual aggregate) <br /> ❑ Increase Aggregate Limits to$2M <br /> ❑ General Endorsement—Professional Coverage Extension CG 88 02 (Ed. 11 85) <br /> ❑ Loss Payable Provisions—CM 78 70(Ed. 06 92) <br /> All other terms and conditions remain the same. <br />
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