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,wxtam VOHM S .FAUL Ee� ;r-2EMENT OR RIDER <br /> t The following spaces preceded by an asterisk(')need not be completed if this <br /> "" '.,:r•' '� endorsement or rider and the bond or policy have the same inception date. <br /> ATTACHED TO AND FORMING PART DATE ENDORSEMENT OR RIDER ° EFFECTIVE TIME ° EFFECTIVE DATE <br /> 'OF BOND OR POLICY N CUTED OF ENDORSEMENT OR RI <br /> DER OF ENDORSEMENT OR RIDER <br /> 400 DZ 3516 3-24-76 12 :01 A.1.1. I 3--24-76 <br /> °ISSUED TO <br /> COOLEY GRAVEL COMPANY <br /> It is hereby understood and agreed that the Obligee on the attached <br /> bond be changed to read as follot <br /> and the BOARD OF <br /> COUNTY COMMISSIONERS of JEFFERSON COUNTY. <br /> Nothing herein contained shall be held to vary,alter,waive or extend any of the terms,conditions,provisions,dgreements <br /> or limitations of the above mentioned Bond or Policy, other than as above stated. <br /> S . PA L FIRE AND MARINE INSURANCE COMPANY <br /> . ,�. ..,. ,r.... .. .... ...By . .� . . <br /> J e Sk Attorney-in-F <br /> I I067 nE5 Rev.b6X hIM.A inU S.A � 5� <br /> t M <br /> 4o� <br />