CERTIFICATE OF LIABILITY INSURANCE (19) ACCOR
CERTIFICATE INSURANCE DATA( D ,
THIS CERTIFICATE IS ISSUED A5 A PATI Of 1929-18
ER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE CaVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,Certain policies may require an endorsement. A statement on
this certificate does not confer ri hts to the certificate holder in lieu of such endorsement sr
PRODUCERCDNTA f�IliEl.LIS
Danielle Roberts !ENIA
aH 2Sw0103 m ani) rxxn a5a
426 North Main Street ILSouthington,CT 0 903
INSURELURER 8:
FARMER MINOR AND DAISY LLC
Ins URER a
436 HILL STREET INSURER E.
E3 1'C3 T 0 010
INSURER F;
COVE GE$ CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE.FOR THE POL16Y PERIOD
INDICATED. NOTWITHSTANDING ANY(REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH 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.
ILT R TYPE OF INSURANCE All L, R tr 6 Y F LIM"
P6LICY NUR1aER.
COMMERCIAL GENERAL LIABILITY
�'-'®r I EA
OCCURRENCE �$ Nm.1 000 000.00
+�,✓ CLAIMS-MADE I OCCUR C PR 1 I�CEa oR0r� W pDO,[l0
!\ SPECIAL FARM PACKAGE !. I MED EXP(Any n) $ 5.01}fI•
A 00
— 0602GI97
-- — 91 120 I B 91312p 9 Fr RsanAL a Aou INJUI Y s ,pI 0,I9pI_CII
GEN'L AGGREGATE Lie1 APPLIES PER-
iEx
GENERALAGGREGATE
POLICY LED JECT .-�Loc 1 PRODUCTS-CO rPIOPAGc $— &Q-0,000:8
I ;
OTHER: ".
$
AUTOMOBILE LIADILITY ( 0.IBiNF-.D SINGLE LIAhIT- $
ANY AUTO i ��Ea aocld�nt)____m_.m,� .�•.�..
I BODILY INJURY(Per peman) +$
OWNED SCHEDULED 1
�--. AUTOS ONLY EAUTOS eODILY INJURY(Peraccident) $
7 HIRED NON-OWNED
AUTOS ONLY ,(AUTOS ONLY j CIPER��DRNRAGE $
r �. .
UMBRELLA LM OCCUR - EACH OCCURRENCE $
..•.EHCL'$'S LIAB CLAIMS-MADE I ' ACsGREGA'TF R• $
DED RETENTI S -. ..
'%%i[7'RrSERS eOM.Pr;nlsArILIN -
ANC3 EMPLOYERS'LIABILITYY f N { UTE_I �
ANY PROPRIETORIPARTNERIEtECUTIVE I .:E.L.EACH ACCIDENT
t3FFICERfMSMBER EXCLUDED? R I A i. i .------._.
(Mandatory In NH) S.L.DISEASE•EA EMPLOYE
If es,descrbe under I _ �---
D SCRIPTION OF OPERATION$glow EL,DISEASE-POLICY LIRA IT $
1DESO.RIPTJON OF OPERA-nOUS!LOCAnONS I VI!HICLES(AGORD SQi,Addlden R.Rie,'n.1k.Sb.d.j.,Fray 139 Ot^9ChBd If"Tam space Is required)
CERTIFICATE HOLDER CANCELLATION
FARMER MINOR AND DAISY LLC SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE
436 FALL STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELrVERED IN
BRISTOL,CT 06010-2906 ACCORDAN WrrH THE POLICY PROVISION&
At3THORIZE RESEWATIHE
019884015rRDO
RD CORPORA TI IN. All rights reserved,ACORD 25(2016/43) The ACO name and logo are registered marks of A