Laserfiche WebLink
Property Damage Liability Includes: <br /> Damage Due to Blasting YES <br /> Damage Due to Collapse YES <br /> Damage Due to Underground Facilities YES <br /> Broad Form Property Damage YES <br />AUTOMOBILE LIABILITY: <br />Policy No. __________________ <br />Effective Date: ______________ Expiration Date: _____________ <br />Insurance Company: <br />(X) Any Auto <br />LIMITS: \[Minimum\] <br />Bodily Injury: <br /> $500,000 each person $1,000,000 each occurrence <br />Property Damage: <br /> $500,000 each occurrence <br />-OR- <br />Combined Single Limit Policy: $1,000,000 each occurrence <br />ARE ANY DEDUCTIBLES APPLICABLE TO BODILY INJURY OR PROPERTY <br />DAMAGE ON ANY OF THE ABOVE COVERAGES: <br />If so, list: Amount: $________________ <br /> \[Not to exceed $1,000\] <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL MAIL TEN <br />(10) DAYS WRITTEN NOTICE TO THE PARTIES TO WHOM THIS CERTIFICATE <br />IS ISSUED. <br /> <br />Dated at _____________________________ On <br />__________________________________ <br /> <br /> BY: _________________________________ <br />Authorized Insurance Representative <br />Version 3/30/3030 - 1 Page 24 <br /> <br />