HomeMy WebLinkAbout07040125 Certificate of Insurance
ACORD. CERTIFICATE OF LIABILITY INSURANCE ~opP 10 s{ OATE (MMJOOlYYYY)
AUARIl 03/26/1:17
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Sky Insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
P.O. Box 2047 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Indianapolis IN 46206-2047
phone: 317-269-4786 Fax: 317-269-4806 INSURERS AFFORDING COVERAGE NAIC#
lNSi.JFiED---. .- .. ---.. .-._-.-,---_._-------- ..
INSURER A" Penn Star Insurance CO.
~~B~._ ..._--~._---~-.~.__.._------~- --..---..-- .
~arian Aye Alternatives/Inc. INSURER c:
-----
S 25 Carve Ave INSURER 0
Indianapolis IN 46220 .--
INSURER E:
COVERAGES
*
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQU!REMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO INHICH 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
... m ""PO' ._---.
LT' NS' TYPE OF INSURANCE POLICY NUMBER d'AW~':MIf~rW\1: DATE MM/DDfYY LIMITS
GENERAL LIABlUTY EACH OCCURRENCE .1 000 000
A -;c"I COMMERCIAL GENERAL ltABIUTY PAC6175650 09{05{06 09/05{07 UAMAUt IUt1tl'llltU .100,000
PREMISES (Ea occurence)
==1=l CLAIMS MADE liJ OCCUR MEO EXP (Anyone penlon) _.5,QOO
---._---~----
PERSONAL & ADV INJURY $1,000,000
-..--- .
GENERAL AGGREGATE .2,000,000
I GEN'L AGGREGATE LIMIT APPLIES PER PROOUCTS . COMPIOP AGG .2,000,000
! POliCY r'W] ~~8T IIl.DC
AUTOMOBILE LIABILITY COMBINED SINGlE UMIT
..u_ .
ANY AUTO (Eaaccidanl)
~.,,- ---.-.- ..-.-. --...
- AlL OWNED AUTOS 800lL Y INJURY
(Per person) .
SCHEDULED AUTOS
- .----."...
HIRED AIITOS BOOll Y INJURY
I- .
NON-OWNED AUTOS (Peraecidenl}
, --...-...--..-..------ ...-- .
i'- PROPERTY DAMAGE
.... (Per acddentl .
GARAGE LIABILITY AUTO ONLY" fA ACCIDENT .
==J ANY AUTO . -.-- -- ---.
OTHER THAN EAACC .
...
AUTO ONLY: AGG .
EXCESS/UMBRELLA LlABUfY EACH OCCURRENCE .
~ OCCUR D CLAIMS MADE .-.---.--.------ ----------
AGGREGATE .
.
=j ~EDUCTmLE ,
..
RETENTION . .
WORKERS COMPENSATION AND I T~l~~Ws I__-.l~lt ,
EMPLOYERS' LIABILITY ."'- -'-.. ---.
ANY PROPRIETOR/PARTNERlEXECUTlVE E.l EACH ACCIDENT .
OFFICERlMEMBER EXCLUDED? Fl. DISEASE - fA EMPLOYEE S
tfY81, deacrib8under --
SPECIAL PROVISIONS belaw E.L DISEASE - POLICY LIMIT , ,
OTHER I
I
DESCRIPTION OF OPERAnoNS, LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Coveraqe appl:i.es to:
Elizabeth Saulsberry - President and
Janet Cambron - Treasurer
CERTIFICATE HOLDER
CANCELLATION
ONESHOT SHOULD ANY OF THE A80YE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSU\NG INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CER1lFICATE HOLDER NAMED TO THE lEFT, BUT FAILURE TO 00 so SHALL
City of Carmel IMPOSE NO OBLIGATION OR LIABfLfTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTAllVE _ / /j"""11/'.ro-
.....~ ~'r<\.''- L.\...
Shanna M. Grizzle - SKY
ACORD 25(2001/08)
@ACORD CORPORA nON 1988