Laserfiche WebLink
<br />I <br /> <br />1!:15116/21!:11!:17 15: 1!:12 7638620102 PAKMAIL <br />Frarn: &Ie P1sa1lel"-l.eae&u. ~ Nwthem ClIpItalIns. Group FexlDl To: J.'snnY ~ <br /> <br />......,. - ...".,..".. .. ...- . -. . -,,-. - .. <br /> <br />PAGE 01 <br /> <br />ACOIJ.IJ. CERTIFICATE OF UABILITY INSURANCE I~ DATIl (MMlDDI'IYY't) <br />mM-f 0&/1810., <br />MaGcvam , "!ahm: IDS ageDOJ' THIS CERnFlCATEIS ISSUED AS A MATTER OF P1FORDllATlON <br />ONLY AND CONFERS NO RIGHTB UPON THE CERTIFICATE <br />Aa'U.iai:a d JIIorthc=D Cap.i1:a1 HOI.DI!R. THIS CERTIPICATB DOES NoT AMEND,'E!XTEND OR <br />e.o. SOX 9398 ALTER THE COVERAGE AfFORDED BY THE POUCIES BELow. <br />Jtift~~lf.a W 55440-9398 INAlCtI <br />Ilone:9B2-99Q-8818 rax:9B2-829-0482 INSURERS AFFORDING eovERAG& <br />iN!liJRm INSl.1RER A: Spozta a lee. ftovie!ezs <br /> I/lISJ.R:R 8: BftJc1e!' a.trft4nts'tzatozs <br />~y SJea1:.e Paz'k INBIlRBl c: <br />:LI8 s't. tISI.RER D! <br />HBm 8 MR 304 <br /> IN8Ul'IiIFlI!: <br /> <br />.. <br />. <br />$ <br />c <br />$ <br />.. <br />. <br />. <br />X I'll I IUI!i <br />E.I_ ~ACClDI:!Nl' 8100,000. <br />E.L OIE\Sli-!:AEMPLOVEE 8100,000. <br />E.L.OI$EAE-POUCYUMrT 8 SOO ,000. <br /> <br />COVERAGES <br /> <br />'ll'tE PQl.lCIiS OF ~ US1ED Bel.OWHA.VS SEEN ISSUED TO 'll4B INSUllED N/lMED ABOIJeFOR TI1ll POLICY PERlOO I!IDICA'IIED. ~1\NDlNG <br />Mi REQlJIRilM!N1'. TERM 011 CQNOmoN Of PNV CQNTRACT OR tm1ER COClJMENT'WI1l1 RESJ'lECTTCl WtIICH 'I11lS CERTIFICA'll: /AA" BE ISSlJE1) OR <br />PlAY P6RTAIN, 'lHa IfoISlJIlAN/%NFOROliID ~ lliE PCl.lC& DeacRIDED ~ IS Sl..IIJJECTTO AU. TH5 mMt, EXCl.lJalONS AND CONDITIONa tr- SUCH <br />POLICIES. AGGReG,.n; lIMITS SHOWN tlAV w.ve ElI!EN RSOUCED BY PAlO Q.AIMS. <br />L'nl1NBlitlll TfPI'l Ol' INSURANCB _ I'OI.KI'I'NUNBgil <br />~ IJABI!.m' <br />~ ~GENERALU~1U1Y 76A2GI.102920S-01 <br />I- --1 CI.AIMS lOOEi [!] QCC:JJR <br /> <br />A <br /> <br />~~ <br />tACI1llCQJ1lRet1Ct <br />07/18/06 0"1/18/0"1 ~~~~, <br />MB) &Xl" /IIny _ D'lI'BOIlI <br />PERSONAl. & PDlINJIJRY <br />GSNERAl. AOOP.EGI\TS <br />PRODUCl'8 - c;wPIOP AGG <br /> <br />GE!I'It. AGGflEC.....TE I.IMI1 APPLIElS PER: <br />II POlJCV n ~ n LOC <br />~OBILB\JABlLItY <br />IWt AUTO <br />f-- <br />,.-- j\lJ, QWN!!D I\UTOS <br />~ S01EDIJl.eI) AUTOS <br />__HlREDAIJTOS <br />I-- NON-CWNeD AIJT'OlJ <br /> <br />CQoIBINED SINGU! I.\MIT <br />lEe ncId9IlII <br />B.OOIL't INJURY <br />(Plr IlOfBO/Il <br /> <br />BODILY INJlJRY <br />(P9r -'dunll <br /> <br />Ml.IA8l1JJY <br />HfM'AUTO <br />~UAaII.lTV <br />j-OCClA 0 CLAIM!l rt.a <br /> <br />~= . <br /> <br />WOftKER8 GaMPENSKI10N ~ <br />BMI'I.O'tIlR8'lJADIIJ1Y <br />B ~~~IVG <br /> <br />mw.~~boIllw <br />-Cl'TflER <br /> <br />~ <br /> <br />AlJfO ONLY- !:AACCIOSNT <br />EAACC <br />Mil <br /> <br />~ <br /> <br />J:ACt!O~ <br />MGREClIA'll: <br /> <br />WC-22-04-1666.,G-01 <br /> <br />10/20/08 <br /> <br />10/20/0? <br /> <br />. OF llPElRATICNS 11.00lli CI.EB I ADDED 1ft' 18PIlllIAL PROW IONS <br />JMm't to be hale! 011 6/16/07 at cen1:e:l:riue Ou'tcloo:r: lazk <br />c:eJ:t:.if'1aate J101dez :l.s !l.amecl as Ad4i'tiolla1 XJ1n%ed. <br /> <br />JJMI1I'l <br />"1,000,000. <br />41 300,000. <br />. &.000 <br />'1,000,000. <br />41 2 ,000,000. <br />$1,000,000. <br /> <br />. <br /> <br />IS <br /> <br />. <br /> <br />.. <br /> <br />CANCEl.LA11ON <br />CDDIlV SHZIlAD Am OF TIl& ABDW DHCRIBIlD I'CILIClll8 BE CANCElooUD BEFORE 1JlB BllPII'ATION <br />DATE! nERflOll, 1III!l UlSUlNElI\lilUR!!R WDJ. B\IIDIJAVOR TO tMIL !!- DAY8 WIVTl'IiIN <br />NOTICB 'Rl1lce CRl1JIICA1Ii HOl.I:lIlR NAMI!!l TO THIl u.F1'. elJT FAIWRIiI 'TtI1lO eo OIAI.I. - <br />IMPOlIIl NO OBlJGmDN OR 1.IARIl.I1Y OF A\IlVICINl) UPCN1lfIi INBUREI\ IT8 AG&NTI OR - <br />RSPRBSENTA1\VBS. . <br /> <br />CERmCATE HOLDER <br /> <br />Ci'l:.Y of cen'te:r:v:il1e <br />hJ:b ~t <br />1880 ~ stzeet <br />cen~11e IlIIN D038 <br /> <br />CiI. <br /> <br /> <br />~'mIS <br /> <br />C!!)ACORD CORPORATlO 1981 <br /> <br /> <br />if{: -16m Sfqftfl ) Cdq 4 6,JeY1Ii/)e. <br /> <br />~~/- Lt;Lq - B{P~ <br />