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HomeMy WebLinkAboutLiability InsuranceFrom:Peggy Fawcett FaxID:812-934-4712 Page 2 of 3 Date:4/7/2009 02:24 PM Page:2 of 3 ACORD CERTIFICATE OF LIABILITY INSURANCE OPID pF DATE (MM/DD/YYl'Y) JEFFE-0 04/07/09 PRODUCER THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Maverick Insurance (NAj HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 826 West Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. New Albany IN 47150 Phone: 812-941-4110 Fax:812-944-8010 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A'. P Y Indiana Public Em to a=s' Plan i INSURER B Houston Casualty Insurance 42374 C ty of Jeffersonville Mayor Thomas Galligan wsuRER c. JeffersonvirlletIN 47130-3672 INSURER D: INSURER E. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH 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 6EEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/Yl') DATE (MM/DDM') LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 , 000 , OOO $ X COMMERCIAL GENERAL LIABILITY PKG90110271 08/06/08 08/06/09 PREMISES (Ea occurence) $ 150 , 000 CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ iD , 000 X Prof Liability PKG90110271 08/06/08 08/06/09 PERSONAL&ADVlNJURV $ 1,000,000 X Law Enforecement PKG90110271 08/06/08 08/06/09 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 3 , 000 , 000 POLICY PRO- LOC JECT AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea eccidenq $ 1 DDO 000 i ~ $ X ANY AUTO PKG90110271 08/06/08 O8/06/Og ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Par person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident] B X $2500 ded PKG90110271 08/06/08 08/06/09 PROPERTVDAMAGE P $ [ er acci~Jent) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO EA ACC OTHER THAI) $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 4 , OOO , OOO $ X OCCUR ^ CLAIMS MADE PKG90110271 08/06/08 08/06/09 AGGREGATE $ 4 , 000 ~ 000 $ DEDUCTIBLE $ X RETENTION $ ],0 , 000 ,$ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY X 70RY LIMITS ER A AIVY PROPRIETOR/PARTNER/EXECUTIVE 0066-0100 07/15/08 07/15/09 E.L. EACHACCIDE3vT $ 1000000 OFFICER/MEMBER EXCLUDED9 If es describe nd EL.DISEASE-EA EMPLOYEE $ 1000000 y , u er SPECIAL PROVISIOIJS Gelow EL DISEASE-POLICY LIMIT $ 1000000 OTHER B Crime/Bonds PKG90110271 08/06/08 08/06/09 Crime 500,000 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS To whom it may concern the insured has crime coverage in the amount $500,000 to substitute for the require blanket bond to insure the faithful performance of all elected officials, employees, commission members and persons acting on behalf of Jeffersonville's Local Government. CERTIFICATE HOLDER CANCELLATION 1111111 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL TO Whom It May Concern IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. ACORD 25 (2001/08) ©ACORD CORPORATION 19RR From:Peggy Fawcett FaxID:812-934-4712 Page 3 of 3 Date:4/7/2009 02:24 PM Page:3 of 3 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08)