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CIVIL SOURCE, INC. - 2012
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CIVIL SOURCE, INC. - 2012
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Last modified
10/21/2013 11:35:37 AM
Creation date
6/6/2012 1:21:01 PM
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Contracts
Company Name
CIVIL SOURCE, INC.
Contract #
N-2012-061
Agency
PUBLIC WORKS
Expiration Date
6/30/2013
Insurance Exp Date
7/20/2012
Destruction Year
2018
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POLICY NUMBER: BA4592L377 COMMERCIAL AUTO <br />CA 20 48 02 99 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />DESIGNATED INSURED <br />This endorsement modifies insurance provided under the following: <br />BUSINESS AUTO COVERAGE FORM <br />GARAGE COVERAGE FORM <br />MOTOR CARRIER COVERAGE FORM <br />TRUCKERS COVERAGE FORM <br />With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified <br />by this endorsement. <br />This endorsement identifies person(s) or organization(s) who are "insureds" under the Who is An Insured Provision of <br />the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. <br />This endorsement changes the policy effective on the inception date of the policy unless another date is indicated <br />below. <br />Endorsement effective <br />05/29/2012 <br />Named Insured <br />Civil Source, Snc. <br />SCHEDULE <br />Name of Person(s) or Organization(s): <br />City o£ Santa Ana <br />Attn: Raui Godinez <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />Re: City Engineering Services. The <br />City o£ Santa Ana and their <br />officers, agents and employees <br />(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as <br />applicable to the endorsement.) <br />Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that <br />person or organization qualifies as an "insured" under the Who is An Insured Provision contained in Section II of the <br />Coverage Form <br />CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1
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