2018/11/26 De Gange Consulting Policy Endorsement THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY.
E4277
Policy Number: 60470-14-61 1st Edition
POLICY CHANGES
Effective Date of Change: 11/26/18 Expiration Date: 12/12/18
Change Endorsement No.: 004 Agent: 99-65-P6J
Named Insured: YANES, BLANCA
DE GANGE CONSULTING
PO BOX 1494
TEMECULA CA 92593
The following item(s):
X Insured's Name Insured's Mailing Address
Policy Number Company
Effective/Expiration Date Insured's Legal Status/ Business of Insured
Payment Plan Premium Determination
X Additional Interested Parties Coverage Forms and Endorsements
Limits/Exposures Deductibles
Covered Property/ Location Description Classification/Class Codes
Rates Underlying Insurance
is (are) changed to read {See Additional Page(s)}:
The above amendments result in a change in the premium as follows:
X No Changes To Be Adjusted At Audit Additional Premium Return Premium
Authorized Representative Signature:
FARMERS
INSURANCE
9IA277 1STEOITION 7-02 Includes(opyrighled Malerial,Insurance Services Office,Inc,with is permission. E4277101 PAGE 1 OF 2
E4277-E01
POLICY NUMBER: 60470-14-61 BUSINESSOWNERS
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES
OR CONTRACTORS
This endorsement modifies insurance provided under the following:
BUSMESSOWNERS POLICY
SCHEDULE*
Name Of Person Or Organization:
CITY OF MENIFEE
Information required to complete this Schedule, if not shown on this endorsement, will be shown in the
Declarations.
The following is added to Paragraph C. Who Is An
Insured in the Businessowners Liability Coverage
Form:
4. Any person or organization shown in the Sched-
ule is also an insured, but only with respect to
liability arising out of your ongoing operations
performed for that insured.
BP 04 50 01 97 Copyright, Insurance Services Office, Inc., 1997 Page 1 of 1 ❑
COMMERCIAL PROPERTY MORTGAGEE
This section is for policy: 60470-14-61
Assembled-on Date: 12101118
Assembled-on Time: 02:55:13