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Last modified
8/15/2023 12:44:44 PM
Creation date
7/28/2022 3:57:59 PM
Metadata
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Template:
Contracts
Company Name
JAS PACIFIC
Contract #
A-2022-072-06
Agency
Planning & Building
Council Approval Date
5/17/2022
Expiration Date
5/16/2025
Destruction Year
2030
Notes
For Insurance Exp. Date see Notice of Compliance
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NAMED INSURED: Jason Addison Smith Consulting Services, <br />Inc. POLICY NUMBER: BA-OS426316 <br />POLICY TERM: 8/8/2021 TO 8/8/2022 <br />COMMERCIAL AUTO <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />BLANKET ADDITIONAL INSURED - PRIMARY AND <br />NON-CONTRIBUTORY WITH OTHER INSURANCE <br />This endorsement modifies insurance provided underthe following: <br />BUSINESS AUTO COVERAGE FORM <br />PROVISIONS <br />1. The fallowing is added to Paragraph A.1.d., Who <br />Is An Insured, of SECTION II - COVERED <br />AUTOS LIABILITY COVERAGE: <br />This includes any person or organization who you <br />are required under a written contract or <br />agreement between you and that person or <br />organization, that is signed by you before the <br />"bodily injury' or "property damage" occurs and <br />that is in effect during the policy period, to name <br />as an additional insured for Covered Autos <br />Liability Coverage, but only for damages to which <br />this insurance applies and, only to the extent of <br />that person's or organization's liability for the <br />conduct of another "insured". <br />2. The following is added to Paragraph 8.5., other <br />Insurance of SECTION IV - BUSINESS AUTO <br />CONDITIONS: <br />Regardless of the provisions of paragraph a and <br />paragraph d. of this part 5. Other Insurance, this <br />insurance is primary to and non-contributory with <br />applicable other insurance under which an <br />additional insured person or organization is the <br />first named insured when the written contract or <br />agreement between you and that person or <br />organization, that is signed by you before the <br />"bodily injury" or. "property damage" occurs and <br />that is in effect during the policy period, requires <br />this insurance to be primary and non-contributory. <br />CA T4 740216 112016 The Travelers Indemnity Company. All rights reserved. <br />Includes copyrighted material of Insurance Services Office, Inc. with its permission. <br />WekMmagm*ADM9Im <br />RtinEwao&APPROVED Br. <br />A,C Auvute <br />® <br />Risk Management Specialist ,' <br />
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