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SAXE-CLIFFORD, SUSAN 7 -2009
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SAXE-CLIFFORD, SUSAN 7 -2009
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Last modified
1/3/2012 2:06:04 PM
Creation date
7/21/2009 1:24:49 PM
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Template:
Contracts
Company Name
SAXE-CLIFFORD, SUSAN
Contract #
N-2009-082
Agency
POLICE
Insurance Exp Date
11/1/2009
Destruction Year
0
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L'1V VVl.(ll t. lV LALILL,/Gl . VA w)VJ.t-1 1VJV !./K V` • A.~ L-s~ YY ~.ali yiulu. au~ <br />C~.'T'YF~CATE ~F INSLTI~ANC~ <br />PLATTE RIVER INSt7RANCE COMPANY <br />C/u: American Professional Agency, Inc. <br />95 Bx'oadway, Amityville, N'Y 1.170]. <br />800-421-6694 <br />This is to certify that tb.e iusuranee policies specified below have been issued by the company indicated <br />above to the insured named herein and that, subject to their provisions and conditions, such policies affoxd <br />the coverages indicated insofar as such coverages apply to the occupation or business of the Named irisured(sj <br />as stated. <br />THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS 02 <br />ALTERS THE COVERAGES; AFFORDED BY THE POLTCY(IES) LISTED ON THIS CERTIFICATE. <br />Nar~3e and Address of Insured: <br />SUSAN S.~'E'-CY~srFGRD, PH.D <br />A PROFESSIONAL CORP. <br />16530 VENTURA EliJD. <br />SUITE 203 <br />ENCINO CA 91436 <br />Addita.onal Named Ynsureds: <br />SUn~7 SAXE-CLIF~'ORI7, ~'i?.LJ <br />APPROVED AS TO F(:)~, <br />~~ rc <br />°~s "`} <br />~„ .. <br />` Laura Stilt Sheedy ~~ <br />Assistant City Attorney <br />~'ype of Work Covered: PROFESSIONAL PSYCHOLOGIST <br />Location of Opex'ations: N/A <br />(Tf diffezent than address lfst~d ahove~ <br />Claim History: <br /> Polio Effective Expiration Limits of <br />Coverages ~ Number <br />II Date Date Liability <br />PROFESSIONAL/ 2,000,000 <br />LIABILI'X'Y 501~.~0137 3/01/09 3/01/10 4,000,000 <br />NOTICE OF CANCELLATION WILL ONLY BE CIVEN TO THE FIRST NAMED INSURED ON THIS <br />POLYCY' AND HE OR SHE SHALL ACT ON BEHALF` OF ALL INSUREDS WITH RESPECT TO GIVTNCp <br />OR RECEIVING NOTICE 4~' CANCELLATION. <br />Comments <br />
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