HomeMy WebLinkAboutSKMBT_C35113042510231VALLEJO INS ASSOC
PO BOX 4446
VALLEJO, CA 94590 020900
THE TOWN OF TIBURON
C 1595 TIBURON BE,
TIBURON, CA 94920
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Additional insured endorsement
Name of Person or Organization
THE TOWN Of TIBURON
1595 TIBURON BL
TIBURON, CA 94920
PRWREIRYT
Policy number: 01828569.9
Underwritten by
United Financial Casualty Company
Inaued-. ROBERT BERMAN
March 21, 2013
Policy Period: Mar 21, 2013 - Sep 21, 2013
Mailing Address
United Financial Casualty Company
PO Box 94739
Cleveland, ON 44101
1-800-444-4487
For customer service, 24 hours a day,
7 days a week
The person or organization named above is an insured with respect to such liability coverage as is
afforded by the policy, but this insurance applies to said insured only as a person liable for the conduct of
another insured and then only to the extent of that liability. We also agree with you that insurance
provided by this endorsement will be primary for any power unit specifically described on the
Declarations Page.
Limit of Liability
Bodily Injury Not applicable
Property Damage Not applicable
Combined Liability $1,000,000 each accident
All other terms, limits and provisions of this policy remain unchanged.
This endorsement applies to Policy Number: 01828569-9
Issued to (Name of Insured): ROBERT BERMAN
Effective date of endorsement: 03/21/2013 Policy expiration date: 09/21/2013
Form 1198(01/04)