2006-12-27 CC - Set Agenda - Laserfiche WebLink

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~ 12/2fi/8fi 89:89:51 DEFAUL res ID -) Pdge BBI ACORD CERTI FICA TE OF LIABILITY INSURANCE DATE i...."VOD!\'V) December 26, 2006 PROOUCER(800)316-6705 i=AX (800)316-6705 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION T. J. Adams Group, a Hilb Rogal & Hobbs Company ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR 333 E. Butterfield Rd., Suite 500 ALTER THE COVERAGE AFFORDED BY THE POlICIES BELOW Lombard, IL 60148 INSURERS AFFORDJNG COVERAGE "."u,.,,:u INSURER A ACE American Insurance Comoanv Centerville Lions Club INSURER B Minnesota INSURER C INSURER D INSURER E COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. :~ TYPE OF iNSURANCE POclCY ~IUMBER ~,;!~1MM'iDD/YYI rokT'E. ti",MlODNY,. LIMITS GENERAL LlABILlTV EACH OCCURRENCE $ 1 000 000 , I-- FIRE DAMAGE (Anyon" lire) 1 000.000 X COMM(;RCII\L GENERAL I..JAIl/lITY $ I-- CLAIMS I.IAOE 0 OCCUR !.lED EXP (Any OM ."""on) S 1.0001 A ~ HDOG21732679 & 09/01/2006 09/01/2007 PEASON,oL &. ADV rNJUFIY $ 1 000000' ~ CSZ0302505 GENERAL AGGREGATE $ 2 000 000 Gi:N'L AGGREGATE LIMIT APPLIES PER PRODUCTS. COMP/OP AGG i 2 000 000 " POUCY nPROJECn LOC 1 . ALJTO~10BILE LIABILITY COMBINED SINGLE liMIT $ Included 1n Above - (Par .ccidanl) ANY AUTO - HDOG21732679 & ALL OWNED AUTOS BC:JILY INJURY - CSZ0302505 ; 09/01/2006 09/0112007 (Par person) S SCHEDULED AUTOS i A- T HIRED AlITOS OWNED AUTOS NOT COVERED BODlL Y INJURY T NON-OWNED AUTOS (?~r .cc'dant) S - - PROPERTY DAMAGE t (Per ..cciden1) GA ~AGE LIABILITY AUTO ONLY. EAACCIDENT . ANY AUTO NOT COVERED OTHER THAN 'E." ACe - AUTO ONLY AGG I EXCESS LIABILITY eACH OCCURRENCE S - o CLAiMS MADE AGGREGATE OCCUR $ - NOT COVERED - $ DEDUCTIBLE i - RETENTION $ s WORKERS COMPENSATION ANO ! ~c~,~~~.;. I OTHER EMPLOYERS' LIABILITY NOT COVERED i E 1.. EACH ACCIDENT S I E L OrSEASE . EA EMPLOYEE S E L. DiSEASE. POLICY LIMIT ! s DESCRIPTION OF OPERATION$!LOCATIONSIVEHICLES/EXCLUSIONS ADDED BV ENDORSEMENT/SPECiAl PROVISIONS rovisions of the policy apply to tbe Centerville Lions Club for their conducting an Ice Fishing Contest at the Centerville Lake in .b..noka County on February 27, 2007 (or on any other dates during the policy period). City of Centerville and Anoh County Sheriffs Office are an additionalinsured(s), but only with respect to liability arising out of the use of premises by the Centerville Lions Club and not out of the sole negligence of said additional insured. ROVISIONS OF THE POLICY DO NOT APPLY TO THE SALE OR SERVING OF ALCOHOLIC BEVERAGES. CERTIFICATE HOLDER ADDmONAL INSURED; INSURER LETTER L City of Cent~vil1e 1880 Main Street Centerville, i\1N 55038 SHOULD ANY OFTHE ABOve DESCRIBED POLICIES BE CANCELED BE."DRE THE! EXPIRATION DATIiTHER60F, TI1E 1SSUING COMPANY WILL ENDEAVOR TO MAIL -1Q...QAYS WRITTEN NOTICE TO TME CERTIFICATe HOLDER NAMED TO THE ~i=T. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVes. AIJTHORIZED REPRESENTATIVE John E. Adams, C.P.C.U. e. :Admrr.b ACORD CORPORATION 198B