CERTIFICATE OF LIABILITY INSURANCE (7)
Date: 1/9/2004 03:09 PM
Sender's Fax ID: McLaughlin Insurance
Page 2 of 2
ACORD.
CERTIFICATE OF LIABILITY INSURANCE
CSR NM
BCGINCl 01 09 04
THIS CERTIFICATE IS ISSUEDASA 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.
PRODUCER
McLaughlin Insurance Agency
828 Lynn Fells Parkway
Melrose MA 02176
Phone: 781-665-2775
Fax: 781-665-0295
INSURERS AFFORDING COVERAGE
NAIC#
INSURED
INSURER A
St. Paul Fire & Marine
General Star National
CNA Insurance Company
Trumbull Insurance C
Ins.
Ins. Co
Boston Concessions Group,
Michael J. DeMarco
55 Cambridqe Parkway
Cambridge SA 02141
INSURER B:
Inc.
INSURER c:
INSURER 0:
any
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAIlE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POlICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR C0llDlT10N OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY llE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE T1ERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAIlE BEEN REDUCED BY PAID CLAIMS.
IN,,, !;.w~ PDUty NUM8ER .o':.~ ;MMlDDJYvj I.:'~Y ~~~J,;~N UMlTS
LTR TVP! OF INSURANCE
OENERAL lJAslLlTY EACH OCCURRENCE S 500,000
- 08/01/04 ~~~~~~~~~ce)
A ][ COMMERCIAL GENEFlAL UtoBUTY CK06901568 08/01/03 s 50,000
- tJ CI.AIMS MADE [!] DCC\R
MEO EX? (Nr1 one penon) S 5,000
r--
][ PERSONAl &NN INJURY $ 500,000
r--
GENEFlAL AG(lREQA TE $1,000,000
t--
GEN'LAGGREGAMIT NlPUES PER: PRODUCTS - COMPfOP AGG $ 1,000,000
Il PRC>- n
POUCY JEer LOC
AUTOMOBILE UABM.ITY COMBINED SNGLE UMIT
I-- S 1,000,000
A ANYAUTO (Ea accident)
-
ALL OWNED -'JJTOS BODILY INJURY
I-- S
c-!- SCHEDULED -'JJTOS CK06901568 08/01/03 08/01/04 (Per pernJn)
~ HIRED AUTOS eOOtL Y IMJURY
S
r-!- NDN.DWNEO AUTOS (Per aCClcJent)
PROPERTY DAMAGE S
(Per acclcJent)
OARAOE UAQIUTY -'JJTQ ONLY - EA ACCIDENT $
R IWY AUTO OTHER THAN EA AfX; $
AJJTO ONLY: AGG $
EXCEBSlUMBREUA UA81Ln'V EACH OCCURRENCE $ 3,000,000
B D OCCUR o ClAJMS MADe NUG-054277Q 08/01/03 08/01/04 AGGREGATE $ 3,000,000
$
~ OEOUCTl8LE $
RETENTION S $
WORKERS COMPEff9ATlON AND X IT~YS~;r,uS I 10TH-
ER
C EMPlOYERS'LIA8IUTY WC255360601 12/29/02 12/29/03 $ 500,000
ANY PROPRlETORIPARTNERJEXECUTIVE E.L, EACH ACaDENT
OFFICERIIVIEMBER EXCLUDED? E.L. DISEASE ~ EA EMPLOYEE $ 500,000
If ye!l, descl1tle under S 500, 000
SPECIAL PROVISIONS below E,L, DISEASE - PDUCY lIMIT
OTH&R
D Liquor Liability VQOOO1684 08/01/03 08/01/04 $500,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDEO BY ENDORSEMENT I 6IpeelAL PROVISIONS Clearwa t+ ~ _...._"'-..._--~
Re: Operations of the Named Insured at the Harborview Center, ,.---.....~...---....
FL -.
I
I ,
; I Vl.;:-. ~OO~
/
j i
CERTIFlCA TE HOLDER
CANCELLA nON
....--........
TOWHOOl
IHOUlD ANY OF THE A8O\IE DE8CRIIlED ~,I&IIIE " ~ QEFOf!& ,THE SllPtRA~' ',. I
DATE THEREOF, THE 'SSutNO INSURER WILL ~D~:;;;; MAii:' -":' - ,~- . -.'... .",io'< ) i t'~s WR1TTI~
~~""'.".....~....,.."
NonCE TO THE CERTIFICATE HOLDER NAMED TO _ LEFT. BUT FAILURE TO DO 10 IHALL
IMP09E NO OBUOAnON OR l.IABILnY OF ANY KttIO UPON 1ME INBUIlER,. lT9 AGENTI OR
To wham it may concern
ACORD 25 (2001/08)