Laserfiche WebLink
Policy Number <br />CPO 9265916-04 <br />THIS ENDORSEMENT CHANGES THE POLICY. <br />PLEASE READ IT CAREFULLY. <br />COMMON POLICY CHANGE ENDORSEMENT <br />Endorsement No. 005 <br />AMERICAN GUARANTEE AND LIABILITY <br />INSURANCE COMPANY <br />Named Insured GTSI CORP. Effective Date: 06-02-12 <br />12:01 A.M., Standard Time <br />Agent Name ARMFIELD HARRISON AND THOMAS Agent No. 66054-000 <br />This endorsement will not be used to decrease coverages, increase rates or deductibles or alter any terms or <br />conditions of coverage unless at the sole request of the insured. <br />COVERAGE PART INFORMATION — Coverage parts affected by this change as indicated by ] below. <br />❑ Commercial Property <br />Commercial General Liability NO CHARGE <br />❑ Commercial Crime <br />❑ Commercial Inland Marine <br />❑ Property Portfolio Protection NO CHARGE <br />Lj <br />The following item(s): <br />71 Insured's Name Insured's Mailing Address <br />Policy Number Company <br />Effective/ Expiration Date Insured's Legal Status/Business of Insured <br />Payment Plan Premium Determination <br />Additional Interested Parties Coverage Forms and Endorsements <br />Limits/ Exposures F7 Deductibles <br />Covered Property/ Location Description FI Classification/Class Codes <br />Rates 1:1 Underlying Exposure/ Insurance <br />is (are) changed to read (See Additional Page(s)} <br />THE FOLLOWING FORM(S) HAS BEEN ADDED: <br />U—GL-1114—A CW 10-02 ADDITIONAL INSURED ENDORSEMENT <br />ALL OTHER TERMS AND CONDITIONS REMAIN THE SAME <br />The above amendments result in a change in the premium as follows: <br />This premium does not include taxes and surcharges. <br />No Changes [:] To be Adjusted at Audit I Additional NO CHARGE ReturnNO CHARGE <br />Tax and Surcharge Changes <br />Additional Return <br />Countersigned By: <br />AUTHORIZED AGENT <br />U -GU -614-A CW (10/02) <br />Insured Copy <br />