|
CERTIFICATE OF LIABILITY INSURANCE DAT"'ODfyyyy)
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER,
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy( ss) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement, A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsernent(s).
<br />PRODUCER
<br />CONTAcr
<br />N ALRE�1
<br />V
<br />NU
<br />1415,30)TH S�RE-.
<br />PHONE A jr,
<br />ALA % fAtj: N
<br />----- --- ---
<br />E W A kL
<br />z 0
<br />LTR TYPE OF INSURANCE INSO Mr) POLtlCY NUMBER
<br />["POIL-ItY
<br />(MWDQYYYY1: WMMC)fyy_yYi LiMItS
<br />A COMMERCIAL GENERAL LJABILiTY 4,R1111 1 IQU'1`8
<br />INSURER A 39.3
<br />iNSLIRE0
<br />INSURER 3 The Frovelers sle.mnq Coripary
<br />SEMENS 110US f Rr, K
<br />INSURER C Jr Id lar PaperCy ""aaj;Aty Co of Aoiorca 21i Cr;
<br />PARKWA'�
<br />INSURER D
<br />B6,FFALO GROI/E, 11. FQE81)
<br />wo
<br />MED EXP Ony �v,o pw,�oW
<br />INSURER F
<br />COVERAGES CERTIFICATE NUMBER, NYC-0I)720W1 3 09 REVISION NUMBER:
<br />TMS IS TO CERTIFY THAT THE POLKAES OF INSURANCE LISTED BELOW HAVE BEEN gSSUED To TIRE INSURED NAMEO ASOVE FOR THE POLICY PEROD
<br />INDICATED N(DI'VOTHs,rANCING ANY REQUIREMENT, TERM OR I.",ONMflOIA OF ANY
<br />CONTRACT OR OTHER OCCUMENT OTH RESPECT TO wHw,H
<br />rHIIS
<br />CERTIFICATE MAY BE kSSUED OR MAY PERrAiN THE INSURANCE AFFORDED BY THE POLIOES DESCIRMED IHEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDffONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PA0 CLAIMS
<br />----- --- ---
<br />EFS..
<br />LTR TYPE OF INSURANCE INSO Mr) POLtlCY NUMBER
<br />["POIL-ItY
<br />(MWDQYYYY1: WMMC)fyy_yYi LiMItS
<br />A COMMERCIAL GENERAL LJABILiTY 4,R1111 1 IQU'1`8
<br />1 0,,t) i, 20 16 0XI 1'(2017
<br />EACH WUPRENCF-
<br />(1100 00
<br />OCCIAk
<br />. . . . . . . .
<br />wo
<br />MED EXP Ony �v,o pw,�oW
<br />'(110 060
<br />aRSONAI &ADVINJURY T1000
<br />000
<br />(3EN1 AGCREGArE 0,10 APPI lES PII�R
<br />GEN ERAL AGGREGAT
<br />X_� JE PRO-
<br />1 "RQfPJC,'rS COMP'OPAGG I
<br />NCL
<br />C AUTOMOBILE LIAMUT� !T`,2,CAP,440L34A 6
<br />10,01,26'6 1101 211'7
<br />COMBINED SINGLE UN UT
<br />2,;x10 C0
<br />Js) x:190AL . .......
<br />X ANY AU 10
<br />NA
<br />X A6 I. SCHEDuLEIJ
<br />A)TOS AU T 0S
<br />....
<br />8001LY NAiRY �Pefacoduli)
<br />..... . ..
<br />NA
<br />x.
<br />Hi+a F 1) A0 IS AIJTOS
<br />. ......
<br />IT
<br />UMBRELLA WAS
<br />EAcil OccuRRENCr
<br />EXCESS LEAS CLAWS -MADE
<br />-- - -------
<br />... ...
<br />I;F,rCNTH)N
<br />S
<br />C WORK ERS COMPENSATION T 0 2i U [344",L12 ,11, 13 iA C S
<br />1010' 2016 201�
<br />x
<br />L I
<br />AND EMPLOYERS' LIASPLI TY YIN MKUUNV)0_,8jl�j (AL MA OR&Wl�i
<br />El IN i A
<br />�1001
<br />1010',2016 10,0Q01i
<br />imm
<br />E L EACHACCOENT
<br />3
<br />000
<br />NXJ0B,1140J�816 �(,'H
<br />(Mandatory Ill NH� r hA)
<br />F, ENSEASE EA EMPq OYEE
<br />5
<br />if des m0e wdqy
<br />D�WP'hON ()F OPIERAIIGNS,,�qfqw ullIH SR
<br />7
<br />E DISEASE POLICYLAW
<br />CEscRIP'noN OF OPERATIONS fLOCAruONSi VEHICLES EACORD 101, AOOHional Rafnarki Schedule, may
<br />be altarhed ifinowe space, is required)
<br />RE K,032C2'015 P4�()JEC'l 310070,138FIROJECF NAME 9CA,,ES, CI F'(QF SAIJA ANA PO1
<br />IU: DEPT
<br />S,'E"i: At AC" iED
<br />CERTIFICATE HOLDER
<br />I T'fJi-"30� I A ANA M 93 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />20 �1,jfV(,,,�'E'V'ER PtAZ4 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />W
<br />34,', MI(A (•A 1 ACCORDANCE WITH THE POLICY PROVISIONS,
<br />AUrHORIZED REPRESENTArtlVE
<br />of Marsh USA Inc
<br />Manash� Mu0erjee
<br />198,8-2014 ACORD CAlMtT7Aff-''rights —reserved.
<br />ACORD 25 (2014/01) The ACORD name and Iogo are registered marks of ACOR�
<br />U 7 0
<br />
|