HomeMy WebLinkAbout07060087 Certificate of Insurance
ACORD~ CERTifiCATE OF LIABILITY INSURANCE I OATE(MlllDDIYYY't')
6/8/20071
PRODUCER Phone: 440 248 4711 Fax: 440 248 5406 THIS CERTIFICATE IS ISSUED AS A MAlTER OF INFORMATION
Britton-Gallagher and Associates, Inc. ONLY AND CONFERS ml RIGHTS UPON THE CERTIFICATE
6240 SOM Center Rd. HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Cleveland OB 44139 I
INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER^,T..,x1 nNt-nn Tn",r-Me "'0 I
Miller Fireworks Company INSURERB'GrRn1 te StRte Inquran"'e Cn. I
501 Glengary Road INSUAEAC:Axis Snecial tv Ins COIn""'anv I
Bolland OB 43528
INSURER 0: I
INStn=lEA E: I
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICy PERIOD INDICATE~.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
ERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL TlIE
TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LLMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I'i"~; ~) ~"<n<. POlICY NUMBER POLICY EFFECTlVE POUCYEXPIRAllON UMrr&
A ~ERALUABIUTY 6990110 10/16/2006 10/16/2007 EACH OCCURRENCE >1 000.600
X OOUUERC~GENEAALU~LITY PREMISES EaOOCUl'enw '50 000'
I ClAIMS MADE IX] OCCUR MED EXP (Any OtB nRrflOn) > ,
I- PERSQ.,lALAf'Oo/ltiJURY $1 000 Ann
I- GENERAL AGGREGATE >2 000 000
r~r--A~EnLlMITA1;lS~R: PROOUCTS. COMPfQP AGG P 000 000
IUUCY I ~C9; LOC !
B ~OMOBllE UABIUTY CA93847704 10/16/2006 10/16/2007 ,
COMBINED SINGLE UIrotIT
lx.. ANY AUTO (Eaaccldef1) >1,000,900
"- ALL QWNEDAUTOS OCJDIlYINJURY i
SCHEDULEDAUTOS """"",oonl > !
I-
elL HlREOAUT03 ocotL Y INJURY I
>
2L /IUN-OWNEDAUTQS (F(lfarekklnl) I
- PROPERTY DAMAGE > I
(Peraa::ld3n1)
==i~GE UA",UTY AlITOONLY-EAACOCENT > I
fJJ.4YAUTO OTHER lliAN EAACC > !
AUTO ONLY: AGO > !
C iJ:SSIUMBRELLA UABfUTY EAU732218 4/23/2007 10/16/2007 EACH OCCURRENCE > 4000000
X OCCUR 0 CLAlMSMAC€ AGGREGATE > 4000000
>
~ ~!XJCTlfli >
RETENTION > ~ ]ij,t >
WORKERS COMPENSATION AND
EMPlOVERS' UABlUTY
mvPROPRIETORIPARTNEMXEo.mVE E.L EACH ACCIDENT >
OFFICERlMEtvBEA EXCLUDED? E.L [lSEASE - EA EMPlOYEE $
~C~~~~b9kNi EL OISEASC - POUey LIMIT >
OTHER
I
DESCRIPTION OF OPERA110NS J LOCATIONS I YEHlCLES f EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS I
ptand Location: MoHawk Landing 11 E. 126th St
fdditional Insured: Rock The Boat Fireworks, Kevin M. Andrews, MoHawk Trivoli PartnerShip, Kosene and Kosene
pevelopement and Management Company
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
Rock The Boat Fireworks (Kevin M Andrews) BEFORE THE EXPIRATION DATE THEREOF, THE ISSOING INSURER
WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE
120 E. 126th St CERTIFICATE HOLDER NAMED TO THE LEFT r BUT FAILURE TO 00 SO
Carmel IN 46032 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON
THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AIlTHORlZEO REPRESENTATIVE #!.l/-t>..t,dWJr>
ACORD 25 (2001 f08)
@ACORDCORPORATION 1988
Property Diagram
Building #1
11 E. 1261b St.
Carmel, IN 46032
Mohawk Landing
Sit.PIlm
w
U6lh Street
! [J-H-H-Ht{]
'"
c
OJ
~ ~
Moha~Land1ng5boppingCenter ,.loc..~+"()n o~ ~J s:
Carmel, Ind.i2IUl 46032 '(L////7
LEG A L DES C R Il'T ION
MOHAWK L"ANDrNG
Lots Numbered One (I) and Two (2) in Newark, an addition to the City of Carmel, in Hamilton
County, Indiana, as per plat thereof recorded in Deed Record #119 pages 7-9 in tbe Office of the
Recorder nfI'amilton County, Indiana, and Lot #3 and the North half of Lot #4 in Newark, as
addition in the City of Carmel. Hamilton County, Indiana, as per plat thereof recorded in Deed
Record #119, Page 7, in the Office ofthe Recorder of Hamilton County, IndianlL
employee
rest
room
~
"
4l
'"
\Q
break
room
office
supply
room
<
Leased Space Diagram
11 E. 126th St.
Cannel, IN 46032
storage
area
<
33 feet
~
"
4l
..
'"
retail showroom--
only area accessible
to the public
exit
elltrance
48 feet
en
)
>
Indiana Department of Homeland Security (IDHS)
Division of Fire and Building Safety
Certificate of Compliance for Retail Sale of Consumer Fireworks (as defined in IC 22-11-14-1)
Certificate Number:
FWT15037
Pursuant to IC 22-11-1
the applicant listed below>
is issued to
." .' ~~~~K:'!(}.k"t:l{i.,.
This Certificate 6f Compliarlce for Retail.Sale of Con~1Jmer Firew'5tks is
~,:,r \;'*;;". >',151,.: ':r4f:~,
the address listed above. Aseparate Certificate of Compliance for Retail
,'(i;f ."'ift'4':;'\t,,-'''''','
be obtained for each tent o;;.sfructure injvhich consumer fireworks are sold.
l! ~:hif 20
,;tWi:': -Jt~
State Fire Marshal:"
ROCK THE BOAT FIREWORKS
14 LIONS CREEK BLVD
NOBLESVILLE, IN 46062
(page 1 of 1)
Covenant of Professionalism
I, Kevin M. Andrews, dba Rock the Boat Fireworks, covenant to abide by the following
standards of professionalism regarding my tenancy at lIE. 126"' S1. Carmel, IN 46032
for the dates of June 4th through July 14, 2007.
I will maintain a business that is in keeping with good taste and public decency. I will do
my part in keeping the building and common areas clean. I will not commit actions
which would disturb other businesses, residences, or traffic by either visual or audio
means. I will not solicit business within the common area of the leased space.
Signed this 3+'"
day of :J u rH.' in the year 2. 0 0'1 .
X~'Vv\. ~
Kevin M. Andrews- owner
Rock the Boat Fireworks
120 E. 126"' S1.
Carmel, IN 46032
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