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-26-99 IION 02:06 PI1 F~X NO, P, 04 <br /> ~,~ ~',,~ ,~'c~r~'v~ "'~ '~:J~'~'~K ~"' NO. 929~ ?. 2 <br /> COMPANY NAME A.'~D PRO, YE£'T / <br /> <br /> INSURANCE VERIFICATION FORM <br /> CITY OF REDWOOD CITY <br /> <br /> It is hereby undefiled and agr,--d thlt the following insuranc[ req~r~mtntl are applicable to I~is project <br /> and tha! thc applitable polic~t, and/or endors~nen~s contain the follow~n <br /> ind&,.te <br /> <br /> x__ Addilzonai irzm~ for C~,ueraJ Lmbi,Uv/and Aulo l.,iability Coverage <br /> <br /> The City <br /> <br /> Primary Coverage <br /> <br /> ~~.x. ..... ?nrmt~ Coverage, Gencnd Liability <br /> X Pr~ Cove. rage, Auto Lia~lity <br /> <br /> With rcs'l~ct to chimt ansu~ out of the opemons Of th= Namgd lnsumt. ~uch illauranc¢ si afforded by this policy <br /> is prin~,'y and is not a&iitional to or contrlbutulR with arly otlm' insman~ carried by or for the b~Mit of the above <br /> Additional <br /> <br /> .... _x___Cross L/ab~, Gen~ L~bili~ <br /> x Cross Liab~ty, Auto Li~iU~ <br /> <br /> ~c n~m~ of mo~ ~ ~e ~non fi~ or ~nuon ~ i~d ~ ~s ~lic~ ~ no~ for ~ <br /> extra,ash ~y nSts of t~ ~m~ ~ ~o~cr, but ~s mdorscm~t ~ ~ ~i~ of m~b~e <br /> aot in~ Ute Xo~ ~b~ of ~e Comfy ~ ~l ~li~. . . <br /> x ,_Notice of C~on for Oen~ Lmbili~ ~d Auto LmbihW <br /> <br /> It Is <~1~i ~d ~ Mt m thc cwcmt of ~cclla~ou of the Poli~ for ~y ~on, ~luding non-~m~t of <br /> p~, J0 day~ ~n nofi~ will ~ ~nt to ~e follo~ug hold. by ~1: <br /> <br /> Ci~ ~ m~woo0 Cio <br /> <br /> ~d Ci~, CA <br /> Aim: En~g ~ Con~ <br /> (650) 7~73~. Pho=~ <br />~.,.,,,,~, ,~.~.,. . , . ....... (650) ~0-7~09, ~ax <br />PL~ F~L ~ ~E SPA~S BELOW AND ~ ~ A CRR~CA~ OF ~$~ TO <br />'~E ADDRESS IJ~TED ~O~ <br /> ~n~M ~ab~ Auto <br /> <br />~'olicy No, JG000032 H07220181 <br /> .............................. <br /> <br />Eff~iv~ DmI~; 03/01/99 03/01/99 <br />Expiration Bait 03/01/00 03/01/00 <br /> <br />N~* Of ~Ce C~r/Comp~y ~e~arket Unde~ri~ers CIaNA? I~s~rance Comp~py <br /> <br /> ) ~v,-- / (si <br /> <br /> <br />