CERTIFICATE OF INSURANCE (206)
CERTIFICAlI~"OF~INSURANCE
I
" J:.
ISSUE DATE (MMIDD/Y'Y(
c.:,;C,
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
,. :...:L;..
... G:~ C' ::::: !..! ;
t'!.t U1.. ; : ;-.~
r'L.
COMPANIES AFFORDING COVERAGE
"'.. ,..
f~~~~NY A
!';
CODE
SUB-CODE
INSURED
f~T~~~NY B
.." i:',_",_) ,....
". T
;cR' iE:i(!f E I 'lED
~<'.' i ; r'-: .
.:. j".
f~T~~~NY C
.. . .:". /!
. ". ." ~..' ".,
.t .}. C
Tj.,1
,",i",t:
,.., i-'j;\ i;;
1 .,n
f~T~~~NY D
SEP21 1990
f~T~~~NY E
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED AB~Ii,~ THp..f.p~~RIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT w\DiF1EiIPECJL,lIQm.tt(Sll;;! THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DDIYY) DATE (MM/DD/YY)
ALL LIMITS IN THOUSANDS
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
BODILY
INJURY
(Per accident)
GENERAL LIABILITY
." -... p.... .-."
,",',",."-"--.'
',,-' /. '..'',""...',
t',')
,..- ("l -j ./~) {"j
. -., .'..' - >,"
;"):~.~.';!) J ..... ()'j
GENERAL AGGREGATE
PRODUCTS-COMP/OPS AGGREGATE
PERSONAL & ADVERTISING INJURY
EACH OCCURRENCE
FIRE DAMAGE (Anyone fire)
MEDICAL EXPENSE (Anyone person)
COMBINED
SINGLE $
LIMIT
BODILY
INJURY $
(Per person)
AUTOMOBILE LIABILITY
'1 }..; /--, -j' L !..
;! ; .," (' J .,/ ../ 1,::
$
PROPERTY
DAMAGE
$
[",j"
(} {"
EACH
OCCURRENCE
$ <$
AGGREGATE
$
$
$
STATUTORY
.i. ,:>(EACH ACCIDENT)
::,(DISEASE-POLlCY LIMIT)
,"., (., (/DISEASE-EACH EMPLOYE
WORKER'S COMPENSATION
AND
EMPLOYERS' LIABILITY
1 1 ~.J ~:~ ".? ~:~ () .4 ".7 ~:~ F
()9/:l5/9() 10/()1/ ~".
OTHER
DESCRIPTION OF OPERA TIONS/LOCA TIONSIVEHICLES/!li'Jfl'flr~~o/SPECIAL ITEMS
..";- ;.;;;":.
. . ".~' ";".
. ... ..
"f '.li"':
.n-c,,_::'.
....-,.;
ceRTIFICATeHQLOER
CANCELLATION
.."..;",1;-.;
i j" c:'
J'.. .'
~- !
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL :::' ':) DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES,
f: T'
", F:
'....LI::.1
-1 i.-.'
";j":;.:.:,..;
AUTHORIZED REP
IVE
'/~.s: cfhf:
@ACORDCORPQRAfION198
ACQAD 25.$(3/88)