Laserfiche WebLink
79 T 3 <br /> his Spectrum Policy consists of the Declarations, Coverage Forms, Common Policy Conditions and any <br /> 02 other Forms and Endorsements issued to be a part of the Policy.This insurance is provided by the stock <br /> AI insurance company of The Hartford Insurance Group shown below. <br /> SBA <br /> INSURER: HARTFORD CASUALTY INSURANCE COMPANY t , <br /> HARTFORD PLAZA, HARTFORD, CT 06115 <br /> COMPANY CODE: 3 .e . <br /> art k <br /> Policy Number: 01 SBA A10279 DW THE <br /> HARTFORD <br /> SPECTRUM POLICY DECLARATIONS ORIGINAL <br /> CI m Named Insured and Mailing Address: JACKAREN CONSULTING LLC <br /> • (No., Street, Town, State, Zip Code) <br /> 4847 152ND PL SE <br /> BELLEVUE WA 98006 <br /> • Policy Period: From 12/13/09 To 12/13/10 1 YEAR <br /> rn 12:01 a.m., Standard time at your mailing address shown above. Exception: 12 noon in New Hampshire. <br /> Name of Agent/Broker: NORTHEAST AGENCIES INC/PHS <br /> Code: 210500 <br /> EN Previous Policy Number: 01 SBA AI0279 <br /> ""I Named Insured is: CORPORATION <br /> Audit Period: NON-AUDITABLE <br /> Type of Property Coverage: SPECIAL <br /> Insurance Provided: In return for the payment of the premium and subject to all of the terms of this policy,we <br /> agree with you to provide insurance as stated in this policy. <br /> — TOTAL ANNUAL PREMIUM IS: $500 MP <br /> iPt.01.;k.(.30) <br /> Countersigned by 10/26/09 <br /> Authorized Representative Date <br /> PM=NM <br /> Form SS 00 02 12 06 Page 001 (CONTINUED ON NEXT PAGE) <br /> Process Date: 10/26/09 Policy Expiration Date: 12/13/10 <br /> INSURED C01)5 0 <br />