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Dalali LLC dba Golden Fleece Billiards 10/14/2020
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Dalali LLC dba Golden Fleece Billiards 10/14/2020
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Last modified
10/28/2020 12:33:02 PM
Creation date
10/28/2020 12:32:38 PM
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Contracts
Contractor's Name
Dalali LLC dba Golden Fleece Billiards
Approval Date
10/14/2020
Council Approval Date
4/29/2020
End Date
5/1/2021
Department
Neighborhood/Comm Svcs
Department Project Manager
Rebecca McCrary
Subject / Project Title
Everett CARES Small Business CDBG Grant
Tracking Number
0002462
Total Compensation
$10,000.00
Contract Type
Agreement
Contract Subtype
Grant
Retention Period
6 Years Then Destroy
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> POLICY CHANGES <br /> 11121 Northfield Insurance Company <br /> St. Paul, MN 55102 <br /> Named Insured Endorsement Number 1 <br /> Dalali LLC DBA Golden Fleece Billiards <br /> Policy Period: From 12/02/2019 To 12/02/2020 Policy Number WS401633 <br /> Changes Effective 09/08/2020 <br /> This endorsement modifies insurance provided under the following: <br /> Commercial General Liability <br /> Commercial Property <br /> Changes <br /> An additional insured is added per attached. A loss payee is also <br /> added per attached. <br /> The following form(s) is ADDED to the policy: <br /> CP 12 18 (10/12) Loss Payable Provisions <br /> CG 20 18 (11/85) Additional Insured - Mortgagee, Assignee, or <br /> Receiver <br /> ENDORSEMENT PREMIUM: $ No Change <br /> NEW TERM PREMIUM: $ No Change <br /> 44,42.•,..„,_ <br /> 09/10/2020 KB 4• <br /> Date Authorized Representative <br /> S101-IL (9/05) Page 1 of 1 <br />
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