Orange County NC Website
Browse       Search
DocuSign Envelope ID:A45C1 1 C6-3162-44FB-82E4-F3B430644D4E <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> GENERAL CHANGE ENDORSEMENT <br /> Attached to and forming part of: <br /> Auto/Garage All Other Effective Date <br /> Policy Number EBA 022 26 14 Policy Number ENP 022 26 14 of Endorsement 08-14-2015 <br /> Issued to MUTER CONSTRUCTION LLC <br /> AgentSENN DUNN INSURANCE, A MARSH & MCLENNAN AGENCY LLC COMPANY <br /> GREENSBORO, NC Endorsement# 30 <br /> PREMIUM INFORMATION <br /> Additional Premium Due at Endorsement Effective Date NONE <br /> Subsequent Quarterly Installments Increased by $ <br /> Revised Quarterly Installment Payment(s) $ 7,280 <br /> It is agreed that the policy is amended as indicated by p <br /> ❑ Policy Installment Premium Amended to: <br /> ❑ Annual ❑ Semi-Annual ❑ Quarterly <br /> ❑ Named Insured <br /> ❑ Mailing Address <br /> ❑ Form(s)Added <br /> ❑ Form(s) Deleted <br /> All Other Reason for Change <br /> AMENDING IA4087 TO INCLUDE <br /> ORANGE COUNTY <br /> PO BOX 8181 <br /> HILLSBOROUGH,NC 27278 <br /> Auto/Garage Reason for Change <br /> COINSURANCE CONTRACT <br /> The rate charged in this policy is based upon use of <br /> a coinsurance dause attached hereto, with the <br /> consent of the insured. <br /> IA-461 6110 <br /> 08-17-2015 16:16 <br /> IA 432912 09 Page 1 of 1 <br />