|
SALEENG-01 MHAMILTONGRAVES
<br /> CERTIFICATE CSF LIABILITY INSURANCE D 111211!266/007Y!20199
<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(iss)must have ADDITIONAL INSURED provisions or be endorsed.
<br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
<br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER License#OE02096 CAN ACT
<br /> DiBuduo&DeFendis Insurance Brokers,LLC PHONE —
<br /> P.O.Box 5479 JAIC,No,Ext):(559)432-0222 �A No):(559)431-7941
<br /> Fresno,CA 93755-5479 E-MAIL
<br /> UD INSURER{S)AFFORDING COVERAGE _. NAIC
<br /> INSURER A:Valley Forge Insurance Co 20508
<br /> INSURED INSURER,B:Transportation Insurance Company 20494
<br /> Salem Engineering Group,Inc. INSURER C:Continental Insurance Company _35289
<br /> 4729 W.Jacquelyn Ave. INSURER D:American Casualty Company of Readin PA 120427
<br /> Fresno,CA 93722 INSURER-E:Continental Casualty Company 20443
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP --
<br /> LT LIMITS
<br /> A I X i COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
<br /> CLAIMS-MADE D OCCUR X 6015893246 12101/2019 12/01/2020 DAMAGE RENTED 300,000
<br /> MED EXP(Any one rsgp)_ 15,000
<br /> -- ----- _PERSONAL&ADV INJURY 2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: 4,000,000
<br /> GENERAL AGGREGATE
<br /> POLICY a JET LOC 4,000,000
<br /> PRODUCTS-COMP/OP AGG_
<br /> OTHER:
<br /> AUTOMOBILE LIABILITY COMBINdEO SINGLE LIMIT 1,000,000
<br /> JX ANY AUTO 6045473729 12/01/2019 12/01/2020 BODILY INJURY Per perso $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS PBRODILY INJURY Per accident
<br /> AUTOS ONLY AUTOS ONLY PeOr acadenl AMAGE $ -
<br /> C X UMBRELLA LIAR X OCCUR EACH OCCURRENCE 5,000,000
<br /> EXCESS LIAR CLAIMS-MADE 6015893232 12101/2019 12/01/2020 AGGREGATE 151000,000
<br /> DED I X I RETENTION$ 10,000
<br /> Q WORKERS COMPENSATION X
<br /> AND EMPLOYERS'LIABILITY PER OTH-
<br /> ANYPROPRIETOR/PARTNER/EXECLMVE YIN 6020581635 12/01/2019 12/01/2020
<br /> OFFICER/MEMBER ry iNEXCLUDED? N/A E.L.EACH ACCIDENT 1,000,000
<br /> E.L.DISEASE-EA EMPLOYE 1,000,000
<br /> D es,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS Delow E.L.DISEASE•POLICY LIMIT
<br /> E Prof./Pollution Liab AEH591395527 12/0112019 12/01/2020 Each Claim 2,000,000
<br /> E Prof.lPollution Liab AEH591895527 12/01/2019 12/01/2020 Aggregate 4,000,000
<br /> I I i
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES'LACORD 101,Additional Remarks Schedule,may be attached If more space is required)
<br /> *'Actual Certificate to be issued upon request
<br /> Certificate Holder is named Additional Insured(including Ongoing&Completed Operations and Primary Non-Contributory Wording)as respects General
<br /> Liability per attached blanket policy form CNA75079XX(10-16).
<br /> **Professional/Pollution Liability deductible per claim-$25,000
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> **SAMPLE CERTIFICATE** THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> AUTHORIZED REPRESENTATIVE
<br /> I
<br /> ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
|