HomeMy WebLinkAboutArtsy-Fartsy FestivalACORD CERTIFICATE OF LIABILITY INSURANCE GSR ~ DATE(MMlDDIY1'11')
300SP-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:812-945-0281 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Auto Owners Insurance CO. 18988
INSURER B:
3U0 Spring LLC INSURER C.
30U Spring , St.
7
30 INSURER D.
Jeffersonville IN 4
1
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 BEEN REDUCED BY PAID CLAIMS.
LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE (MMIDDIYI') DATE {MMIDDIYI') LIMBS
GENERAL LIABILRY EACH OCCURRENCE $ 10 U Q o U o
A X X COMMERCIALGENERF,LLIABILITY 09730369 Q6/U1/09 Q6/O1/1D PREMISES (Eaoccurence) $ 30UDUU
CLAIMS NU1DE ~ OCCUR MED EXP (Any one person) $ 10000
PERSONAL & ADV INJURY $ 10 U O O D U
GENERAL AGGREGATE $ 1000000
GEN'LAGGREGATELIMITAPPLIESPER: PRODUCTS-COMP/OPAGG $1000000
POLICY jE7 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 OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESSfUMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR ~ CLAIMS MADE AGGREGATE $
DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND TORY LIMITS ER
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNERlEXECUTIVE
E.L. EACH ACCIDENT
$
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS /LOCATIONS !VEHICLES !EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS
Halls-Other than Not For Profit. City of Jeffersonville is Additional
Insured for General Liability for Special Event on September 18, 2009.
CERTIFICATE HOLDER CANCELLATION
CITYO-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3U DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Clty Of Jeffersonville IMPOSE NO OBLIGATION OR LIABILfTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
5U0 Quartermaster Ct. REPRESENTATIVES.
Jeffersonville IN 47130 AUTHt~I'7ED~REPRESENTATIVE ~ ~ , t