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Last modified
10/22/2015 2:52:38 PM
Creation date
10/22/2015 1:46:34 PM
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Contracts
Company Name
VA CONSULTING
Contract #
A-2015-174
Agency
PUBLIC WORKS
Council Approval Date
8/4/2015
Expiration Date
8/4/2019
Insurance Exp Date
11/24/2015
Destruction Year
2024
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VA CONSL1t FING, INC RFCA 814115 AGR # TBU REVIEWED BY <br />P01_ICY A. sAdau 81,5,18 <br />P . <br />I_.UNIGE I hR EfAIA { OF 0) <br />COMMERCIAL AUTO <br />CA 20 48 02 99 <br />THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. <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 ofthe Coverage Form apply unless modi- <br />fied by this endorsement. <br />This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provi- <br />sion of 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 />- -- — <br />EndorsemenfEffective: a /z7Jzole CountersgnedBy: <br />Named Insured: <br />VA Consulting Inc - <br />_.._ (Authorized Re resontative) <br />SCHEDULE <br />Name of Person(s) or Organizatfon(s): Re; All Opera tions as pert.aino to named insured. <br />'She City of Santa Ana, its officers, employeas, <br />agents, volunteers and representatives <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 <br />that person or organization qualifies as an "insured" wider the Who Is An Insured Provision contained In Section II <br />of the Coverage Forrn. <br />CA 2048 02 99 Copyright, Ins Ience Services Office, hic., 1998 <br />
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