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HomeMy WebLinkAboutCertificate of Liability Insurance' -_ 1 ,acoizcP CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDlYYYY) 01/17/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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). PRODUCER MARSH USA INC 500 WEST MONROE STREET CHICAGO, IL 60661 Attn: CAROL RADWANSKI 312-627-6278 500892-SAGEM-CAS-10-11 MTI CONTACTNAME: PHONE FAX INC No. Exit: (A/C, Nol: E-MAIL ADDRESS: PRODUCER CUSTOMER ID 1: INSURER(S) AFFORDING COVERAGE NAIC 4 INSURED Safran USA, Inc. MorphoTrak, Inc - Attn: Thierry Boillot 1145 Broadway Plaza, Ste. 200 Tacoma, WA 98402 INSURER A : Liberty Mutual Fire Ins Co 23035 INSURER B NIA NIA INSURER c : Liberty Insurance Corporation 42404 INSURER o :NIA N/A INSURER E : INSURER F: CHI-003582433-01 REVISION NUMBER: vTHIS 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. ILTRR ., .,. . _ -TYPE OF -INSURANCE ADDL INSR SUER WYD POLICY -NUMBER-".... .. _ . POLICY EFF (MM/DDIYYYYI POLICY EXP (MM/DDIYYYY) . - . LIMITS • A GENERAL LIABILITY TB2641438914020 07/01/2010 07/01/2011 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ CLAIMS -MADE I X OCCUR MED EXP (Any one person) • $ 10,000 . PERSONAL BADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY PR� LOC $ A AUTOMOBILE LIABILITY AS2641438914010 07101/2010 07/01/2011 COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ X H NON -OWNED AUTOS • $ $ X COMP $2501COLL $1000 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LEAS I CLAIMS -MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ C WORKERS COMPENSATION WA764D438914030 (DEDUCTIBLE) 07/01/2010 07/01/2011 X WC STATU- I OTH- TORY I IMITS ER AND EMPLOYERS' LIABILITY YNNI 1,000,000 C ANY PROPRIETOR/PARTNER/EXECUTIVE WC7641438914040 (RETRO) 07/01/2010 07/01/2011 E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below WA STOP GAP { ) E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) City of Miami is an Additional Insured as respects their interest in the operations of the Named Insured as required by written contract regarding General Liability. CERTIFICATE HOLDER CANCELLATION City of Miami Attn: Joy Saunlett 400 NW 2nd Avenue Miami, FL 23128 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Katey E. Jones ACORD 25 (2009/09) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD