HomeMy WebLinkAboutCertificate of InsuranceCERTIFICATE OF LIABILITY INSURANCE 10f2712010
AS A NIA TER OF INFORMATION ONLY AM COWERS NO RIGI-ITS WON TI-IECERTWICATE Hmmv_
CERTWICATE DOES MOT AFFIRMATVIVELY OR INEGATWELY AMEND, EXTEND OR ALTER THE COVERAGE AMMED BY THE KKJCIES
BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORfZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIRCATE "OLDER.
is an ADDfl IONAL INSURED. the p*cy(tes) fruist be erxiotsed, It SUOROGATION iSWAIVED. subod to
Ow term and widititift of the poiicy� certan policies mW rowtv mi endomenw-rd, A ztvvrv*fvt c n this owb5culp doft W cortle, rvtft to the
ov'Acate hokwr irt lieu of such endomeffiert(s).
Conw Name Lon aodW
Como Insursom AlIency 41010 77 - 28 791 Oil F�ft . . . . ... .....
PO sox 160 ow. No. FXI) No):
Sin ipswv! It, SC 2MI E-Mail: want2bo4lmh&mtcorn
INSURERS) AFFORDING COVEPAGE NAIL
INSURER A intwslaff., Fire 3 CasuakyCorm;mny
C-rL BadW EviliMims, Itic dba Ch"k-n-LAxis Emortainment IN6URER 13, 'Natior�31 Unon Fite Irmurance Comparw (S)
499 SW Namoft Pbim
Port St Lucie, FL 34953 _s LIRFR C.
INSURER 1),
GENET AL. LIABILITY
COMMFROAL ORWRAL LM81I i ry
CV4M& MADE CCCUR
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OFNL AWREGATE 11MIT AMC-$ PER
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AUTOMOB II,E LIABILITY
ANY AUTC>
ANED SCHFOULLD
A Air" AMOS
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FORM AUTQS 7 NON-COMED
AUrOS
UNOWLLA f1AB OCCUR
EXCESS LM CLAMS-MADE
DCO RE71`14TION $
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Y00WERSCOMPENSA17ION
AM EMPLOYERS! LIABILITY
ANY PWPRtETORtPARTNERF_XErAfnVE yN
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DESCRIPI'M OF OPERATIONS oW..
i I
RIEV00N NUMBER.
IISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE ,FAIR THE POLICY PERIOD
M OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WH#CJ4 I'HIS
)RANGE AFFORDFO BY Tf IE POLICIES DESCRIBED HEREIN IS StJnJF-& TO ALL THE TEMS,
S SHOWN MAY HAVE BEEN REDUCED BY PAD CLAIMS.
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S14G 91121151 3111r1010
ORYLIMITS vz
3f7lr2f3t1 AOW"sft St00,090
f Accidert Medical Expanse Seneft $10.000
j Deductible None
1) saj-k -IP"'" ON O—FOP—ERA-T-kik S-1 -LO CX1, *1 0-F-4-S 7 V, El- 11 CLE S J.A%sc h ACORD 10'1, Additional R m na ft Sche &ft, it mora sp3 m is M**ed)
Pmw EqLApnwnt Reftwo Opemboas 60cated at 499 SW Narmatt Place Port St Lude, Ft- 34953- CerVicate Holder As Additional Insired
A°mjwment devkas on (go w4h the �r krapeciaj evengs) dated I IISM10 to 11912010 k>r;ated at 650 US-1, Sebastian, FL :329
CERTIFICATE HOLDER; CANCELLATION
The Sebastian C4anmbake Foundabon, Inc. ISiiOULDANY OF TT4E A80VE DESCRIBED POL3CIE5 SE CANCELLED BEFORE THE
PO Sex 7ON36 EXPIRATION OAS E I HEREOF, NOTICE WILL BE DELIVERED IN
Sdmmhan FL. 329M ACCORDANCE WITH THE POLICY PROVISIONS,
v
ffHORIZED REPRES WATM
ACORD 25 010105) The ACORD naivie and logo are registered marks of ACORD 0 1988-2010 ACORD CORPORATION. All tights resemd,
nounoq 7, IU8AA e 6 0 L 6z 10C
regale
3' QO6,DOJ
ProdtJCW COMPWW OpOnilioft
AW
$1,000,000
Per"al -d Advwl.*V "urif
$1.000,000
3111,2011 Efftploy" Beneft
41,000.0m
Fire Damage
$100.000
Mad" Expenw3
Excluded
4* trmumd RelWion
$2,500
COMITWO SINGLE UmtT
7$-
acdomrt)
KAJ-Ry
$
pcf amid"
f
(por 0=kI&M
ORYLIMITS vz
3f7lr2f3t1 AOW"sft St00,090
f Accidert Medical Expanse Seneft $10.000
j Deductible None
1) saj-k -IP"'" ON O—FOP—ERA-T-kik S-1 -LO CX1, *1 0-F-4-S 7 V, El- 11 CLE S J.A%sc h ACORD 10'1, Additional R m na ft Sche &ft, it mora sp3 m is M**ed)
Pmw EqLApnwnt Reftwo Opemboas 60cated at 499 SW Narmatt Place Port St Lude, Ft- 34953- CerVicate Holder As Additional Insired
A°mjwment devkas on (go w4h the �r krapeciaj evengs) dated I IISM10 to 11912010 k>r;ated at 650 US-1, Sebastian, FL :329
CERTIFICATE HOLDER; CANCELLATION
The Sebastian C4anmbake Foundabon, Inc. ISiiOULDANY OF TT4E A80VE DESCRIBED POL3CIE5 SE CANCELLED BEFORE THE
PO Sex 7ON36 EXPIRATION OAS E I HEREOF, NOTICE WILL BE DELIVERED IN
Sdmmhan FL. 329M ACCORDANCE WITH THE POLICY PROVISIONS,
v
ffHORIZED REPRES WATM
ACORD 25 010105) The ACORD naivie and logo are registered marks of ACORD 0 1988-2010 ACORD CORPORATION. All tights resemd,
nounoq 7, IU8AA e 6 0 L 6z 10C