|
SALEENG-01 MHAMILTONGRAVES
<br /> ,4�ort� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)
<br /> 11126/2019
<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(ies)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 /> License#OE02096
<br /> PRODUCER CAO ACT
<br /> DiBuduo&DeFendis Insurance Brokers, LLCJJ
<br /> PHONE FAX
<br /> P.O.Box 5479 Ale,No,Ext):(559)432-0222 559
<br /> Fresno,CA 93755-5479 E-MAILOD (ac,No):( )431-7941
<br /> INSURER(S)AFFORDING COVERAGE NAIC p
<br /> -- _ INSURER A:Valley Forge Insurance CO 20508 _
<br /> INSURED INSURER B:Trans ortation Insurance Com an 20494
<br /> Salem Engineering Group,Inc. INSURER C:Continental Insurance Com an 35289
<br /> 4729W,CA 93722 Jacquelyn Ave.
<br /> Fresno, INSURER D:American CasualtyCompany of Read in PA 20427
<br /> Fres
<br /> 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 7DLSUBRL TYPE OF INSURANCE POLICY NUMBER POLICDY EFF POLICY EXP LIMITSA X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
<br /> CLAIMS-MADE X OCCUR893246 DAMAGE TO RENTED 12/01/2019 12/01/2020 PREMISES(Ea occurrent 300,000
<br /> MED EXP(Any oneperson) 15,000
<br /> PERSONAL&ADV INJURY 2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 4,000,000
<br /> I-�
<br /> POLICY I "l PE� 11 LOC 4,000,000
<br /> PRODUCTS-COMP/OPAGG
<br /> OTHER:
<br /> B $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT X 1,000,000
<br /> OWNED SCHEDULED
<br /> AUTO 6045473729 12/01/2019 12/0112020 amdttW_BODILYINJURY Per arson' $
<br /> OWNED
<br /> AUTOS ONLY AUTOS
<br /> N-S BODILY INJURY Per accident $
<br /> AUTOS ONLY ATOS ONE PROPERTY
<br /> racddent AMAGE
<br /> Pe $
<br /> C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000
<br /> EXCESS LIAB CLAIMS-MADE 6015893232 12/01/2019 12/01/2020
<br /> AGGREGATE 5,000,000
<br /> DED I X I RETENTION$ 10,000
<br /> D WORKERS COMPENSATION PER OTH-
<br /> AND EMPLOYERS'LIABILITY X
<br /> ANY PROPRIETOR/PARTNER/EXECUIIVE YIN 6020581635 12/01/2019 12/01/2020 1,000,000
<br /> PFFICER/MEMBER EXCLUDED? �Y N/A E.L.EACH ACCIDENT
<br /> Manddeory In
<br /> If yes,describe under E.L.DISEASE-EA EMPLOYE 1.000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1,000,000
<br /> E Prof./Pollution Liab EH591895527 12/01/2019 12101/2020 Each Claim 2,000,000
<br /> E Prof./Pollution Liab EH591895527 12/01/2019 12/01/2020 Aggregate 4,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 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 /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
|