Orange County NC Website
Browse       Search
Named Insured <br />KRISTY MATALA <br />Endorsement Number <br />001 <br />Policy Symbol <br />OGL <br />Policy Number <br />G71879562 <br />Policy Period <br />07/22/2023 to 07/22/2024 <br />Effective Date of Endorsement <br />07/22/2023 <br />Issued By (Name of Insurance Company) <br />ACE American Insurance Company <br />Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. <br />CC-1K11k (04/22) <br />SIGNATURES <br />THE ONLY COMPANY APPLICABLE TO THIS POLICY IS THE COMPANY NAMED ON THE FIRST <br />PAGE OF THE DECLARATIONS. <br />By signing and delivering the policy to you, we state that it is a valid contract. <br />INDEMNITY INSURANCE COMPANY OF NORTH AMERICA (A stock company) <br />BANKERS STANDARD INSURANCE COMPANY (A stock company) <br />ACE AMERICAN INSURANCE COMPANY (A stock company) <br />ACE PROPERTY AND CASUALTY INSURANCE COMPANY (A stock company) <br />INSURANCE COMPANY OF NORTH AMERICA (A stock company) <br />PACIFIC EMPLOYERS INSURANCE COMPANY (A stock company) <br />ACE FIRE UNDERWRITERS INSURANCE COMPANY (A stock company) <br />WESTCHESTER FIRE INSURANCE COMPANY (A stock company) <br />436 Walnut Street, P.O. Box 1000, Philadelphia, Pennsylvania 19106-3703 <br /> BRANDON PEENE, Secretary JOHN J. LUPICA, President <br /> _________________________________ <br /> Authorized Representative <br />Insured Copy <br />DocuSign Envelope ID: 7CBF367B-4F5C-4DA1-A542-6B5E57D6A1CD