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RUFFIN, DON AND ARLENE
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RUFFIN, DON AND ARLENE
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Last modified
4/4/2022 4:06:00 PM
Creation date
6/20/2019 4:29:23 PM
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Contracts
Company Name
RUFFIN, DON AND ARLENE
Contract #
N-2019-108
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Destruction Year
2025
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POLICY NUMBER: 6BRPG0000006932900 <br />INTERLINE <br />IL12011185 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />POLICY CHANGES <br />Policy Change <br />Number 1 <br />POLICY NUMBER <br />POLICY CHANGES EFFECTIVE <br />COMPANY <br />6BRPG0000006932900 <br />01/01/20 <br />Nationwide Mutual Insurance Company <br />NAMED INSURED <br />AUTHORIZED REPRESENTATIVE <br />Arlene Ruffin <br />K&K Insurance Group, Inc. <br />COVERAGE PARTS AFFECTED <br />COMMERCIAL GENERAL LIABILITY COVERAGE <br />CHANGES <br />The following form SRPG8018 is added to the policy. <br />C P#2191 <br />Authorized Representative Signature <br />IL 12 01 11 85 Copyright, Insurance Services Office, Inc., 1983 Page 1 of 1 <br />Copyright, ISO Commercial Risk Services, Inc., 1983 <br />
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