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    Endorsement Schedule:: Policy Number

    Uploaded by

    Efraim John Hernandez
    This document is an endorsement schedule for a cargo inland transit policy. It adds two vehicles, a 2010 Mitsubishi L-300 and a 2016 Nissan NV350 Urvan, to the covered conveyances. It also removes a 1996 Mitsubishi L300 and a 2019 Hyundai H100 from the covered conveyances. The endorsement does not change any other terms or conditions of the original policy.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Endorsement Schedule:: Policy Number

    Uploaded by

    Efraim John Hernandez
    52 views2 pages
    This document is an endorsement schedule for a cargo inland transit policy. It adds two vehicles, a 2010 Mitsubishi L-300 and a 2016 Nissan NV350 Urvan, to the covered conveyances. It also removes a 1996 Mitsubishi L300 and a 2019 Hyundai H100 from the covered conveyances. The endorsement does not change any other terms or conditions of the original policy.

    Original Title

    12557503490680034856_2

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    This document is an endorsement schedule for a cargo inland transit policy. It adds two vehicles, a 2010 Mitsubishi L-300 and a 2016 Nissan NV350 Urvan, to the covered conveyances. It also removes a 1996 Mitsubishi L300 and a 2019 Hyundai H100 from the covered conveyances. The endorsement does not change any other terms or conditions of the original policy.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    52 views2 pages

    Endorsement Schedule:: Policy Number

    Uploaded by

    Efraim John Hernandez
    This document is an endorsement schedule for a cargo inland transit policy. It adds two vehicles, a 2010 Mitsubishi L-300 and a 2016 Nissan NV350 Urvan, to the covered conveyances. It also removes a 1996 Mitsubishi L300 and a 2019 Hyundai H100 from the covered conveyances. The endorsement does not change any other terms or conditions of the original policy.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    Client's Copy

    ENDORSEMENT SCHEDULE
    To : : EJLH MARKETING AND DELIVERY SERVICES Policy Number : DS-CGO-500317127
    Issue Date : 02/27/2020
    Address : 56 Bulihan
    Malvar Client Number : 50077225
    Agent Number : 50000928
    Batangas
    Referral Number : SI-191024046/MRN-190006206
    4233
    Ext./Prev. Policy Number : - / SI-CGO-500216917
    Insured : EJLH MARKETING AND DELIVERY SERVICES Estimated time of
    Departure and Arrival : As stated in this schedule
    Business : Endorsement (500101440)

    SUMMARY OF PREMIUM AND OTHER CHARGES


    PREMIUM ................... PHP 0.00
    Value Added Tax ................... PHP 0.00
    Documentary Stamp Tax ................... PHP 0.00
    Local Government tax ................... PHP 0.00
    AMOUNT DUE ................... PHP 0.00

    CLASS OF INSURANCE : Cargo Inland Transit


    LIMIT OF LIABILITY : FIVE HUNDRED THOUSAND PESOS ONLY (PHP 500,000)

    ITEM/S COVERED : As per Policy schedule

    DETAILS OF INSURANCE
    Origin : As per Policy schedule
    Destination : As per Policy schedule
    Type of Conveyance : As per Policy schedule
    Bill of Lading :
    Consignee :
    Type of Packing :

    Warranties and Clauses LOSS OR DAMAGE, IF ANY, IS PAYABLE TO

    AS THEIR INTEREST MAY APPEAR, SUBJECT TO THE TERMS AND CON DITIONS, CLAUSES AND
    OF THIS POLICY. IT IS HEREBY EXPRESSLY UNDERSTOOD THAT THIS OR ANY RENEWAL
    THEREOF SHALL NOT BE CANCELLED WITHOUT PRIOR WRITTEN NOTIFICATION TO AND
    CONFORMITY OF

    THE POLICY, POLICY SCHEDULE, SPECIFICATIONS AND ANY ENDORSEMENTS WILL BE READ AS ONE CONTRACT
    Documentary Stamps to the value shown herein have been affixed/imprinted to the premium register of the company in compliance with Revenue Regulation No. 15-2001 dated October 16, 2001
    In witness whereof, the company has caused this Policy to be signed by its duly authorized representative. This document with the e-sign of Standard Insurance Co. Inc.'s authorized representative is
    system generated and serves as your official policy.

    LEDESMA DS2MBU Preview Copy


    IMPORTANT REMINDER:
    Please do not forget to check the correctness and accuracy of the details on the Policy Schedule. This will serve as the basis in the assessment and settlement of a claim. Any discrepancy or non-declaration
    may cause inconvenience or even nullification of a claim. Should there be any correction/s or change/s, inform your agent or writing office IMMEDIATELY.
    Attached to and forming part of SICI Policy Number : DS-CGO-500317127 (EN 500101440)
    Effective Date : 02/19/2020
    It is hereby declared and agreed that this policy is being endorsed amended as follows:

    A. Inclusion of units as part of the Conveyances as follows:

    1) 2010 MITSUBISHI L-300


    PLATE NO. : NAQ-600
    ENGINE NO. : 4D56AAC7073

    2) 2016 NISSAN NV350 URVAN


    PLATE NO. : OV4746
    ENGINE NO. : YD25385417A
    CHASSIS NO. : JN1TC2E26Z0005462

    B. Deletion of units

    1) 1996 MITSUBISHI L300 FB


    PLATE NO. : ULA-483
    ENGINE NO. : 4D56A-F6228
    CHASSIS NO. : L039PYZ1-10363

    2) 2019 HYUNDAI H100 2.5 CRDi GL 6MT SHUTTLE BODY


    PLATE NO. : K1F844
    MOTOR : D4CBK796304
    SERIAL : KMFZBX7KAKU670284

    All other terms and conditions remain the same.

    ---------- NOTHING FOLLOWS ----------

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