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HomeMy WebLinkAboutCallistus Smith (Auto)CSR RB ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MMlDDIYYYY) 3ooSP-1 09/02/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Callistus Smith Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 3415 Paoli Pike ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Floyds Knobs IN 47119 Phone:812-944-7711 Fax:812-945-U281 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Auto Owners Insurance Co. 18988 INSURER B: 300 Spring LLC wsuRER c 3UU Spring St. INSURERD , Jeffersonville IN 4713Q 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 CONTRACTOR 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 BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE (MM/DDlYY) DATE (MMlDD/YY) LIMffS GENERAL LIABILfTY EACH OCCURRENCE $ l U Q U Q U U A X X COMMERCIAL GENERAL LIABILITY 09730369 Q6/O1/U9 06/01/10 PREMISES (Eaoccurence) $ 3000OU CLAIMS MADE ~ OCCUR MED EXP {Any one person) $ 10000 PERSONAL&ADVINJURY $ 1000000 GENERAL AGGREGATE $ looooo0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 1 Q Q Q Q Q 0 POLICY jEa LOC AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident} ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) - PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO EA ACC OTHER THAN $ AUTO ONLY: qGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ~ CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND P ' - - TORY LIMITS ER EM LOYERS LIABILITY ANY PROPRIETOR/PARTNERfEXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? If e d ib d E.L. DISEASE - EA EMPLOYEE $ y s, escr e un er SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS /LOCATIONS 1 VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT! SPECAL PROVISIONS Halls-Other than Not For Profit. City of Jeffersonville is Additional Insured for General Liability for Special Event on September 18, 2009. GtK I IhIGHI t t1UWtK CANCELLATION CITYO-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Cl ty Of Jef fersonvi Ile IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 500 Quartermaster Ct. REPRESENTATIVES. Jeffersonville IN 47130 AUTH ED REPRESENTATIVE Mf,.VRV GB tLUV I/U6f " ©ACORD CORPORATION 1988