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HOANG, KHAI
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Last modified
6/15/2022 10:04:19 AM
Creation date
12/24/2019 8:03:09 AM
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Contracts
Company Name
HOANG, KHAI
Contract #
N-2019-264
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Expiration Date
12/31/2020
Destruction Year
2025
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POLICY NUMBER: 6BRPG0000006933600 <br />INTERLINE <br />IL 12 01 1185 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />POLICY CHANGES <br />Policy Change <br />Number 2 <br />POLICY NUMBER <br />POLICY CHANGES EFFECTIVE <br />COMPANY <br />6BRPG0000006933600 <br />01/01/20 <br />Nationwide Mutual Insurance Company <br />NAMED INSURED <br />AUTHORIZED REPRESENTATIVE <br />Khai Hoang <br />K&K Insurance Group, Inc. <br />COVERAGE PARTS AFFECTED <br />COMMERCIAL GENERAL LIABILITY COVERAGE <br />CHANGES <br />The following SRPG8018 form is added to the policy. <br />CP# 1564 <br />Authorized Representative Signature <br />IL 12 0111 85 Copyright, Insurance Services Office, Inc., 1983 Page 1 of 1 <br />Copyright, ISO Commercial Risk Services, Inc., 1983 <br />
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