HomeMy WebLinkAboutCOI - Esmeralda Owen - Expires 2023-05-01PROGREJJ/UE°
COMMERC14L
FUSCO & ORSINI INSUR
5095 MURPHY CANYON RD
SAN DIEGO, CA 92123
CITY OF GILROY OFFIE
7351 ROSANNAST
GILROY, CA 95020
M91HOWMD
NOV 0 7 2022
GILROY CITY CLERK'S OFFICE
Additional insured endorsement
Policy number: 03630662-3
Underwritten by:
United Financial Cas Co
Insured:
ESMERALDA OWEN
October 29, 2022
Policy Period: Nov 1, 2022 - May 1, 2023
Mailing Address
United Financial Cas Co
PO Box 94739
Cleveland, OH 44101
1-800-444-4487
Name of Person or Organization For customer service, 24 hours a day,
CITY OF GILROY OFFIE 7 days a week
7351 ROSANNAST
GILROY, CA 95020
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: 03630662-3
Issued to (Name of Insured): ESMERALDA OWEN
WILLIAM OWEN
Effective date of endorsement: 11/01/2022
Form 1198(01/04)
Policy expiration date: 05/01/2023
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