HomeMy WebLinkAboutCertificate of Liability Insurance
JUL. -20' 06(THU) 10:23
LOY & FORDYCE
TEL:812 883 3238
P.002
ACORD. CERTIFICATE OF LIABILITY INSURANCE OP 10 c~ DATI;' IMN/DDIV'NYI
'1'EMPL-l 07120/06
PRODUCEll THIS CERTIFICATE IS ISSUEC AS A MATTER OF INFO~MAT[ON
oy & Fordyce Agency, Inc. ONLY ANO CONFERS NO RIGHTS UPON THE CERTIFICATE
'::'11 top Plaza HOLDER_ THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
'/.0. Box 484 ALTER THE COVERAGE AFFORDED BV THE POLICIES BELOW.
SallMll IN 47167 INSURERS AFFORDING COVERAGE \ NAIC #
Phone: 812-883-3150
IN~--- -- --- 0,:!SURER A' . Aut.o Owne~:J In$u~ance Co \- I ~
Temple , ~emple Excavating INSURfR II, ---~--
, -----
INSURER C I
paV1n~, Inc:. I
1367 State Road 60 ~SURERD -='~~- I -.-
Salem IN 47167 "i-'-
INSURER E.
I COVERAGES
A-I
04/19/06
-8iW i~'b-mmrr- - \,IMllS
EACH OCCU"RENce l' 1$1 ,000,000
'O~OR~- , .
04/19/07 PREMises (fa OCCUlD"ee)
~ (;';;;;;;;'0") I $ 10 , 000
~PERSONAL&ADVINJUR'I', S 1 ,000,000 ,
GENEAALAGGREGATE ~OOO, 000
\ PROOUC~S-COMP'.O~AaG i 51 ,~OO_
,.
~"I
\
I
96-366-021-00
04/19/06
04/19/07
f-
\ $ 1,000 I 000
1.~l,OOO/OO~
'sl,OOO,OOO
l
-: OEDUCTIS~E
RETENTION $
WORKERS COMPI1.NSATION AIlfEl \
EMPLOYERS' UA8111T\'
A ANYPROPRIETORIPA~NERlEXECUTIVE 1711702 0914ll)5
OFI'ICERIMEMIIER EXCLUDED?
~~~~I~l'::O'v':~~~s b.~... I
OTHER \
A \ aented Equipment 1726002 09159896 OS \ 10/11/05 10/11/06 \
DESC;II11'nON OF QPERA nONS I LOCA TIO>lS I VEHICI.ES I EXCLUSIONS ADDED lilY ENDORSEMENT I SPECIAl. PROVISIONS
04/19/06 \
04/19/07
AutO ONl. Y - EA ACCIDENT ~ S
\. OTI4EFl TI-lAN EA ACC \""! -
AUTO ONL V AGG ' S
e~C~OCCURRENCE I $ ~ ,000, OO,~_
AGGREGATE --r;-:2 ,000,000
~._-
I>
1\
10/06/05
10/06/06
I TORY LIM'TS
Ii L El\CH,ACCID'ONT _ $ 500,000
E L DISEASE. EAEMPLO't'EE $ 500,000
I E.L.OISEAse-POLI~YLIMt'r 5500';000-
is
Rented Eq
300,000
City of Jeffe~sonville
SOl C:ou~t Ave
Jeffersonville IN 471~0
CANCELLA'rION
CI'I'YOF3 SHOULD AN'" OF TllE ABOve DeSCRI8ED "aLICIES BE CANCELLED 8&FORE TMIi GllPIRATlON
DATE THERI!OF, THE ISSUING INSURER WlI.L ENDEAVOR TO MAIL ~ DAYS IMUTTEN
NOllCE TO Ti-lli CERTIFICATE HOLDER IlIAMED TO THE LEFT,ouT FAILURE TO 00 $0 SHALL
I'll POSE NO OBlIGATION 011 LIAlilll'T'f' OF A.tlY KIND UPOIII THE Ii'lSUIlER.ITS AGeNTS OR
REPAESENTA riVES.
AUTHQRlZliD REPRESENTA nVE
: CEiRTlF1CATE HOLDER
PiCORD Z5 (2001/DB)