Laserfiche WebLink
<br />.' , <br /> <br />AIX SPECIALTY INSURANCE COMPANY <br />1~6 EXCHANGE STREET, SUITE 10~tl BlJl=J:ALO. NY 14210 <br /> <br />GENERAL CHANGE ENDORSEMENT <br />i FOLICY NO. CCZ -CL~021735-0 <br /> <br />II <br /> <br />NAMED INSURED AND MAILING ADDRESS <br /> <br />AGENCY AND MAILING A.DDRESS <br /> <br />20019 <br /> <br />Chris Rauls <br />DBA: Betterview <br />1047 EL Camino Rear. Suite 203 <br />Menlo P~rk.CA 9402S <br /> <br />Commodore InSfJrance Services <br />2340 Powell St, #308 <br />Emeryville, CA 9460B <br /> <br />POLICY PERIOD: From 03/0912010 to 03109/2011 at 12:01 am standard time at your mailing address shown above <br /> <br />Endorsement: 001 <br />Effect1ve 03/11/2010 this policy is amended as shown: <br />COMMERCIAL GENERAL LIABILITY <br /> <br />For en additional/retum premium, the ftems below are changed as ;ndicated: <br /> <br />THE FOLLOWING IS ADDED AS ADDrTIONAL INSURED ON FORM CG 2010 1001 WITH PRIMARY AND <br />NON...cONTRrBUTING WOROrNG ON FORM AGL 0115 0508 <br /> <br />ADDITIONAL PREMJUM; $250 <br />PRO RATA FACTOR: 0.0 <br /> <br />DATE: 03/12/201 0 BY~ <br /> <br />C~ <br /> <br />COUNTERSIGIlfSC AT: <br /> <br />AUTHORI2ED RePRESENT"nVE <br /> <br />IL 1Z0111 85 <br /> <br />PegCl 1 of 1 <br />