HomeMy WebLinkAboutES05-336 - Other - Standard Insurance Company - Basic Life Insurance Policy Endorsement - 09/05/2009 K Records MariTgemehI6
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WASH IN GTON Document
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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: &Fi4mi-3p, z L,L F= ,
Vendor Number:
3D Edwards Number
Contract Number: i Ssos- 33(0
This is assigned by City Clerk's Office
Project Name: BPS(e_ 1--(Pt
Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ❑ Contract
%Other: 6� _Ley 2�1V.r2���'�-1��T
Contract Effective Date: Termination Date: f L � +q
T--
Contract Renewal Notice (Days): p41 —
Number of days required notice for termination or renewal or amendment
Contract Manager: AtjrJkq��)(�Department: FocieLogtt- LP-z-OLc S
Detail: (i.e. address, location,, parcel number, tax id, etc.):
5 Public\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08
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 Corporatc Secretary
339619-D,City of Kent,LT