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SIEMENS INDUSTRY, INC. 15A -2016
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SIEMENS INDUSTRY, INC. 15A -2016
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Last modified
6/9/2017 2:03:45 PM
Creation date
5/31/2016 2:27:34 PM
Metadata
Fields
Template:
Contracts
Company Name
SIEMENS INDUSTRY, INC.
Contract #
A-2016-054
Agency
POLICE
Council Approval Date
4/5/2016
Expiration Date
11/30/2016
Insurance Exp Date
10/1/2017
Destruction Year
2021
Notes
a-2015-277
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AGENCY CUSTOMER lD: W0129 <br />LOC #: fvfOrrlStOWrl <br />Page 2 of 2 <br />AGENCY <br />NAMED INSURED <br />MAR ,H Tj,3A N( <br />3VAENS iNDvSTR,, Ac <br />EIJI! "'W" r"CHNO�.CGES <br />POLICY NUMSER <br />10(116 DEE Rf--,'E PARK1h,"O' <br />K,FFA�.o ,ROVE tI- �300)9 <br />CARRIER <br />NAIL GC1aE <br />EFFECnVE DATE <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE; Certificate of babiliky Insurance <br />RE 91,T2Pf,,Y)7119G0 P093'2(rX)W5 "RQ( EC F# 9'I Q)(,'7C5�3 "R,0JE;17 NAW b(,'Ad 'SE'S C I 'Y QF SAW A ANA P(A ICE D&P F <br />c11,f oir rA %NA i rrE ()F,CERG, EMPLOYEES. A (]EN F, AND VCLUIN"F=1-RS ARE iNCUXED AE ADCA 1'10NAL INSURED UNDER 1"HE A BOVF REP ERIN(' ED <br />GENFRX [,%I',� I J'f A NO AUTOMOBILE ( ABIUTY I NSUPA�9,�' POIJ0ES A NID THE (OvERATaF- AFF�)RrEC r HE A D01"NONAL I NSUPkH) IJND�p r HE:, P QE5 <br />rrr,A-A'�"Ar MAi�,l'aEti',-RON,IFliEiE6 ',L.GENCEDFI)IrME�f3]NL'9r'Sr{:"' (NC ORM� <br />RAC,"% TRACTrOPS ANTI R ESP EC; " TO Ai .,Pv�fPr'1r I11r1' 3 ;IF T 9 N SU RK 31j 7 (.NT,. W'H RE ,;P;: <br />NAMED NIJR,'F,-D NU P UR CER'7 [FICA C:-' HOLDER 1JN DER 1-(,N SRA ,,,, r <br />Jr." )Wh cR AND C ON 'RAC FC R NA IvE A I. I- R�((i Fq l SAGA �N S' EA(,H 0 �'�IER AN D AN'f'0 THEIR C' 01,TTRACTOR 3USCONTRA;,711RS <br />,�SEhjr3 ANCLWLOYEES <br />rOoCDAYS F�;JCR TO !'IEDRYWR17EN( . jNT5VG Ir NPjlC pj; :S <br />7p <br />ACORD 101 12008101) '� 2008 ACORD <br />The ACORD name and logo are registered marks of ACORD <br />M <br />JC � , 0 ��, <br />, 1 * 2 1 <br />
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