HomeMy WebLinkAboutES05-336 - Other - Standard Insurance Company - Group Long Term Disability Insurance Policy Endorsement - 09/05/2009 Records Ma emen
KENT
WA9H1NGTON Document
CONTRACT COVER SHEET
This is to be completed by the Contract Manager prior to submission
to City Clerks Office. All portions are to be completed.
If you have questions, please contact City Clerk's Office.
Vendor Name: V
Vendor Number:
JD Edwards Number
Contract Number: e56s-, 336,
This is assigned by City Clerk's Office
Project Name: L_pMG`_ I 27-i2Yn 1� i-p4ay�.CV1 ZJVSue-Pvf--Xcl-ll
Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ❑ Contract
C�.Other: PO UCCy e Ucpo1---> /L 1t-NT'
Contract Effective Date: 9 - S- 09 Termination Date- tAA
Contract Renewal Notice (Days): la
Number of days required notice for termination or renewal or amendment
Contract Manager:,?)tekY at�-Department: C—Ar L47 /2-p- - ,Zylc�
Detail: (i.e. address, location, parcel number, tax id, etc.):
S Pub lic\Records Management\Forms\ContractCover\adcc7832 1 11108
GROUP INSURANCE POLICY ENDORSEMENT
Attached to and made a part of Group Policy
Issued to City of Kent as Policyholder under
Group Policy 339619-D
Effective September 5, 2009, the following endorsement is attached to and made a part
of the group insurance policy referenced above
The Allocation Of Authority provision has been removed in its entirety
STANDARD INSURANCE COMPANY
By
president Corporate Secretary
339619-1),City of Kent,LT