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2000_0327_packet
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2000_0327_packet
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12/14/2009 1:49:06 PM
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Roseville City Council
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Council Agenda/Packets
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CERTIFICATE O� ,I1VSi�RANC� D�-OS-DO <br />is is issue as a matter o in ormation on y an confe�ra no rig ts up�on certificateholder. This certificate <br />dneq not ameAd, extend or alter the coveragas afforded by the policy be�o�v, <br />'1'his is to eertify tbat the pohcy otinsurance listed below has been issued to the insured named below tc <br />the policy period indicated, notwithstanding a�ay requirement, term or condition of any contract or other <br />document with respect to wlucb� �this certificate may be issucd or may pertain, tlie insurance afforded by <br />the policy d�4crihed herein is su�ject to all the terms, exclus�ons and conditions of sueh policy. <br />Insured: <br />USA WATER SKI <br />AWS,A,ITS MEIV�BER CLUBS,CQAC:HES, <br />O�FICLA►LS, USA WATkR SKI <br />799 OVERLOOK DRIV� <br />1�VxNTEl.t HAVEN, FL 33884 <br />Policy #�: DREA2300090998 <br />I�as. Co.: U.S. Fidelity & Guaranty <br />Producer: <br />Su�livan & Strauss Ageucy,Inc. <br />One Hollow Larae <br />Lake Success, NY 11042 <br />T el : 800-225-6560 F ax : 516 - 3 6 5- 3 615 <br />Effective DAt�: <br />Expiration Date: <br />January �, 2000 <br />January 1, 200� <br />TYPE OFYN3URANCE LIMTTS (in thousgnds) <br />Commercial C�eneral Liability General Aggregate $ NONE <br />(Occurrence korm) En�h Occuxrencc $ 1,000 <br />Products/Completed Ops Aggregate $1,000 <br />Fire Damage Legal Liability Any one fire $ 50 <br />Medical Expense Any one person $ 5 <br />Participant. T.egal Liability Included <br />REMA1tI�S: <br />The Certi�xcatoho�der(s} shall be an Additional Insured, but only witli respec <br />operations of t�e Named Insured and only �in accordance with tb�e provisions <br />of �ndorsemcnt AG 4004- � 1/97 Designated Person Or (.)rganization. <br />OWNED WATERCRAF'T LIABILITY EXCLUDED <br />Certiflc.ate Holdar. <br />Additional Insured 410-00006 <br />ALL CLUBS A,F'FILIATED R'�I THE <br />��uc�rr w,��x s� Assoc��rzo�v <br />00000 <br />CANCELLATION <br />t to the <br />and limitations <br />Shouldthe above policy becaneelled before <br />the dnts of expirshrna, t2ie isauiu�g cnmp8qy will <br />endeavor to mai130 days writt�a notice to the <br />named certificate holder, but failure to mail such <br />notice sbalI impose no obligation or liability ofauy <br />kind upon the company, ite age�ata or representatives. <br />Autb.orized Reproscntative: <br />� Q, y��l1M�% <br />
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