Laserfiche WebLink
POLICY NUMBER: 6BRPG0000005515500 <br />INTERLINE <br />IL12011186 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />POLICY CHANGES <br />Policy Change <br />Number 2 <br />POLICY NUMBER <br />POLICY CHANGES EFFECTIVE <br />COMPANY <br />6BRPG0000005515500 <br />02/13/15 <br />Nationwide Mutual Insurance Company <br />NAMED INSURED <br />AUTHORIZED REPRESENTATIVE <br />Maria L Madrigal <br />K&K Insurance Group, Inc. <br />COVERAGE PARTS AFFECTED <br />COMMERCIAL GENERAL LIABILITY COVERAGE <br />CHANGES <br />The following forms,CG2011 & SRPG8018, is added to the policy in regards <br />to City of Santa Ana, its officers, agents, <br />and employees. <br />CP# 4540 <br />"^`i- /A� <br />Authorized Representative Signature <br />IL 12 01 11 86 Copyright, Insurance Services Office, Inc., 1983 Page 1 of 1 <br />Copyright, ISO Commercial Risk Services, Inc,, 1983 <br />