Laserfiche WebLink
POLICY NO: <br />PHPK1362709-001 <br />19-0141a-cel:na«Z90414111u11#4 . III III <br />CHANGE # 4 CHANGE EFFECTIVE: 07/06/2016 <br />Philadelphia Indemnity Insurance Company ( PRODUCER: Maguire Insurance Agency, Inc. <br />NAMED INSURED: Illary Archilla <br />MAILING ADDRESS 1 Dover <br />Trabuco Canyon, CA 92679- <br />POLICY PERIOD: FROM 07/06/2016 TO 07/06/2017 at <br />12:01 A.M. Standard Time at your mailing address shown above. <br />DESCRIPTION: <br />In consideration of the premium reflected, the policy is amended as indicated below: <br />Endorse to add primary and non-contributory wording In favor of the following entity. The City of Santa <br />Ana, it's officers, employees, agents, and representative. <br />Total Annual Total Prorate <br />Additional/Return Premium $0.00 Additional/Return Premium $0.00 <br />Total Annual Total Prorate <br />Additional/Return Additional/Raturn <br />Tax/Surcharge/Fee $0.00 Tax/Surcharge/Fee $0.00 <br />Page 1 of 1 <br />