Orange County NC Website
Browse       Search
• <br />POLICY NUMBER: CU 2013877 COMMERCIAL LIABILITY UMBRELLA <br />CU 22 4012 04 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />POLICY CHANGES <br />Ties endorsement modifres insurance provided under the following: <br />COMMERCIAL LIABILITY UMBRELLA COVERAGE PART <br />Effeclive Crate of Change: 1€119107 Policy Period: 10tl/07 TO 10/IM8 <br />Change Endorsement No.: 1 Agency Code: 816279 -150 <br />Named Insured: RESOLUTE BUILDING COMPANY SEE CU 7202 (0305) <br />Agent': WACHOVIA INS SERVStRALI; IGH <br />The following Item(s): <br />Insured's Name <br />Policy Number <br />ElEffWMUPExpiration pate <br />Payment Plan <br />Additional interested Parties: <br />mumblExposures <br />Covered Property/Located Description <br />FInsureds Mailing Address <br />Company , <br />Insureds Leo StatuslBusiness of Insure! <br />Premium Determination <br />0 Coverage Forms and Endorsements <br />ElSelf- Insured Retention <br />Classificebon/Class Cddes <br />Underlying Insurances <br />Is (are) changed to react (See Additional Page(s)j: r <br />IT IS AGREED THAT ENDORSEMENT C - CANCELLATION NOTInC..ATION IS ADDED AND ATTACHED <br />HERETO. <br />The above amendments result in a range In the premium as follows: <br />NO CHANGES TO BE ADJUSTED ADDITIONAL PREMIUM RETURN PREMIUM <br />AT AUDIT ANNUAL <br />PRO RATA <br />Endorsement Ef%ctifve: 1 0119107 Countersigned By: Insurance Co.: - I<)12 5 / 1) ? <br />AMi RISURE MUTUAL INSURANCE COMPANY (Authorized Representative) <br />iCU 22 4012 04 0 ISO Properties. [no., 2004 Page 1 <br />