HomeMy WebLinkAboutexhibit 4-certificate of insurance.............................
DATE (MM/DD/YY)
12/12/2003
PRODUCER
ARC Excess & Surplus, LLC
901 Route 168, Suite 202
Blackwood, NJ 08012
INSURED
Unisys Corporation
P.O. Box 500
Blue Be].]., PA 19085
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
COMPANY National Union Fire Insurance
A Coin
COMPANY
B
COMPANY
C
COMPANY
D
COVERAGES,
THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MMIDD!YY)
POLICY EXPIRATION
DATE (MMIDDNY)
LIMITS
GENERAL LIABILITY
MMERCIAL GENERAL LIABILITY
S MADE r I OCCUR
OWNER'S & - ✓I RACTOR'S PROT
GENERAL AGGREGATE
$
PRODUCTS-COMP/OP AGG
$
PERSONAL & ADV INJURY
EACH OCCURRENCE
FIRE DAMAGE (Any one fire)
$
MED EXP (Any one person)
$
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
COMBINED SINGLE LIMIT
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
GA
RAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
OTHER THAN AUTO ONLY:
EACH ACCIDENT
AGGREGATE
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS' COMPENSATION AND
EMPLOYERS' LIABILITY
THE PROPRIETOR!
PARTNERS/EXECUTIVE INCL
OFFICERS ARE;
EA • CURRENCE
AGGREGAT
EXCL
STATU-
TORYWC M T$
EL EACH ACCIDENT
OTHE
EL DISEASE - POLICY LIMIT
EL DISEASE • EA EMPLOYEE
$
A
OTHER
PROFESSIONAL
LIABILITY
360-89-47
10/17/
2003
10/17/
2004
US$15, 000, 000 AGGREGATE
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/SPECIAL ITEMS
ER'I IFICATE'` H QLDER
City of Miami
444 S.W. 2nd Avenue
Miami FL 33130
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELED BEFORE
THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
or-
CORPOI ° • TI014 37'993'I