HomeMy WebLinkAboutCertificate of Liability Insurance[32i 08 1394 08: 14 3055535588
MAR" LOPEZ
PAGE 0'2
002
PE'RSETECO1 6ULI
AST, CERTIFICATE OF LIABILITY INSURANCE
ARDOuCele
Af Insurance Group
P.O, Box 90589
Alton., GA 34004
(67l) 724-1000
PaP411 TOMRObala! Inc. AndlOr !bt
Subsidiartea
1 f dle Sanctuary Pann gy
Suits 200
Alpharetta. GA 30004
DAT$ ILeualyrri
f 111104
THIS CERTIFICATE its IS J D AS A MATTER OF INioRMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. TNIB CERTIFICATE DOS NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOw,
IMBU'NSRS AFFORDING COVERAGE
CCVERAQES
rKti I a St. Paul Fire & Marina
rN..uarael. St Paul FIR, and Casualty Compalry
Pavel, Xslr'lon American lccomma Company
INiWfR o.
$A1C #I
LIALFSP
THE POUCIES OF INSURANCE USTE0 BELOW HAVE SEEN Ii.SUED TO THE INSURED NAMED ABOVE FOR 111E POLICY PERIOD INDICATED. NOTWITI•ISTaa01NG
ANY REOLORESI MAY PERTAIN, ME INSURAN, TERai CE AFFORDED 8Y THE POLICIES ODFIDeTION OF ANY pf9CRiOR eECi NE.REIN IS ILMECT TO ALL THE R DOCUMENT loVrT11 RESPECT TO ,TERMS. EX .t,Ue1ON5 AND CON4 ioNSISSUED
F 54,101
POLICIES. AG4iREGATE LA TTI Bi1OVai MAY HAVE SEEN REDUCED 8'' PAID CLAIMS,
Wi. De • • .. • rpLle+' MAIM 11M Y 1n1 i aLKY : 11
QA+MW i1AMutr
A X odARErrcuL OEM0eAL LWLrt• 631403605 311104 . S11 /06
JDoeA
i [1:��pe
LINT
i
A= oMOELa Lleas.nY
-X
ANT Ann
ALL COARCO A V=
oo•acue,D mnoe
PaNfD Al/tm
rikiCAMAI D A 1104
await uaaarr
ANY AUTO
HcrtmcnbLE
aenpaloN
waroom coamana ioN APO
awtzra v
Lc c+LcxuaaoE rea, Owls, weir
nm•.f
brew
OTHER
D aorstonmarrudeArorm 1 wroc .ee l arcLu ruui ApptQ are illi;aciewirterr 1 Ivey MONSOON*
The City of Miami is Included as an additional Insured ate their In oneats may appear,
TEOBQ03130S
WAX
311103
CERTIFICATE I4QLDR
W0119e240 03
Oepsl'tlnent of FIne Rescue
Me. Julia Martin
444 LW. 21Id Avenual,1001 Roar
MIe1MN, PL =IS0-
1�CC51lD meta*
3M /05
LAATO
EACH OC'Ci_REACE
1 1, 0O0, Obp
vate+w�A�iFJ nI
a 1.00O,o0o
men DP TNw .. orionl
a 10, 000D
PEASOPQ. 4 AC+v rN.Ugr
1 T,000. l-
aeTe kocotw re
1 1,004,000
PaoruJem • CowCA ACC
a 1. 000,000
Icoilmro .saPoLE Limn'
1,000,000
OCCiLYieLERy
lower]
w
BODILY d• i1 r
�
Iaaaee+ii
$
pavan If Y a u4AGE
IPR +cwdaMS
AUTO! ONLv • EA AcCiCaNT
1
011 ER T) 1 0, m74
1
NJT00ILY- ACKI
1
84GM 0cc4.44:ocz
Alagesi TE
e.L Ew+►tCwcAT
a 1,000,000
rt4 rn4FA3E-Pr.tuPLOTC'E
1 1,000,000
i G L. Nett*. PC4 .;v purr
1 -- 1,006, 000
CANGELLATIDH
449001.0 Arm 00 nre mow PGYomeso /CLJC'#V M CANC.:µww PMORL Tha *AFlRA1]0IJ
O&M Y141$1110:10, ThR *iota nwutne YNLL UMW VON TO NAIL 30 0AY9 LAi1T11','N
»I>Ci TO 1 4 CL4nNICAT11 Houma rump 113 TNa LCAT, OUT FAA.UAC, TO DO ILA WALL,
IMAM C OILLOAT101J OR LNbt,r1V or ANY OM UPON nee Murex rT$ AGGNITy arT
AUTPIOPARD 11IWNTAt1Yil _
ACOM COrtYORAT ION -loss
02/ 06 / 1.3 4 08: 14 3055538568 MARY LOPE2
11/01/2004 16:20 kU
PAGE @
Goa
PERSETEco1 t3uu
IMPORTANT
rtthe certificate holder is an AnDIT1ONAL INSURED, the policy(lee) must be endorsed. A statement
on this certificate does not wnfer rights to the certificate holder in lieu of such endore+ement(s), •
if SUBROGATION IS WANED, subject to the terms and condition' of the policy, certain policies may
require en 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 aide Otis form doss not cnnrtitrta a contract between
the Issuing Insurer(s), authorised representative or producer, and the certificate holder, nor does it
affirmatively or negatN+ely amend, extend or s?tnr the coverage afforded by the policies I.ietnd thereon.