Laserfiche WebLink
- THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> � . � ADDITIONAL INSURED ENDORSEMENT <br /> � This endorsement modifies insurance provided under the following: <br /> COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> PRODUCTS/COMPLETED OPERATIONS COVERAGE PART <br /> OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART <br /> INSURED: <br /> TOMMY HOUSE TIRE COMPANY INC <br /> 340 E MACON ST <br /> DECATUR IL 62521 <br /> 1. WHO IS AN INSURED for "bodily injury" and "property damage" liability is amended to include the Additional <br /> Insured specified below but only with respect to liability arising out of your operations or premises owned by <br /> or rented to you. <br /> 2. The insurance does not apply to "bodily injury" or "property damage" liability arising out of the sole negligence <br /> of the Additional Insured named below. <br /> 3. We agree to notify the Additional Insured named below at the address stated below of any cancellation of, or <br /> � material change to, this policy. <br /> Relationship of the Additional Insured to the Insured: <br /> AS RESPECTS 10 PARKING STALLS LOCATED AT 339 E <br /> WASHING ST DECATUR, IL. TOMMY HOUSE TIRE CO INC <br /> LEASES THESE PARKING STALLS FROMT THE CITY OF DECATUR. <br /> FEDERATE� ' <br /> INSURANCE� ,, <br /> FEDERATED MUTUALINSURANCECOMPANY �� <br /> Home Office: 121 East Park Square <br /> Owatonna,MN 55060 <br /> Phone:507-455-5200 I <br /> Additional Insured Name and Address : '�I <br /> CITY OF DECATUR <br /> � #1 CIVIC CENTER PLAZA I <br /> DECATUR IL 62523 <br /> Includes copyrighted material of Insurance Services Office, Inc, with its permission. <br /> CG-F-11 (05-92)-1 Policy Number: 9134119 Effective: 01/27/97 <br />