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Item 16 - Agreements for A -Tech Consulting, Inc., Dudek, and Leighton Consulting, Inc. for On -Call Various Environmental Services
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Item 16 - Agreements for A -Tech Consulting, Inc., Dudek, and Leighton Consulting, Inc. for On -Call Various Environmental Services
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4/3/2024 11:32:45 AM
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City Clerk
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Agenda Packet
Agency
Clerk of the Council
Item #
16
Date
10/18/2022
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DocuSign Envelope ID: D88FA102-A4A5-4F89-BB27-3941CF5F6548 <br />Attachment Code: D574651 Certificate ID: 16765248 <br />POLICY NUMBER: BAP0146329 <br />COMMERCIAL AUTO <br />CA20481013 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />DESIGNATED INSURED FOR <br />COVERED AUTOS LIABILITY COVERAGE <br />This endorsement modifies insurance provided under the following: <br />AUTO DEALERS COVERAGE FORM <br />BUSINESS AUTO COVERAGE FORM <br />MOTOR CARRIER COVERAGE FORM <br />With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless <br />modified by this endorsement. <br />This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage <br />under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided <br />in the Coverage Form. <br />This endorsement changes the policy effective on the inception date of the policy unless another date is indicated <br />below. <br />Named Insured: DUDEK <br />Endorsement Effective Date: 8/28/2022 <br />SCHEDULE <br />Name Of Person(s) Or Organization(s): <br />ANY PERSON OR ORGANIZATION TO WHOM OR WHICH YOU ARE REQUIRED TO <br />PROVIDE ADDITIONAL INSURED STATUS OR ADDITIONAL INSURED STATUS ON <br />A PRIMARY, NON-CONTRIBUTORY BASIS, IN A WRITTEN CONTRACT OR <br />WRITTEN AGREEMENT EXECUTED PRIOR TO LOSS, EXCEPT WHERE SUCH <br />CONTRACT OR AGREEMENT IS PROHIBITED BY LAW. <br />Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br />CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 2 <br />
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