HomeMy WebLinkAboutMiscellaneous - 412 FOSTER STREET 4/30/2018 / 412 FOSTER STREET`~
f
210/104."181_0000
OP ID R DATE(MM/DD/YYYY)
ACORD CERTIFICATE OF LIABILITY INSURANCE MUGFO-2 11/07/03
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
C J McCarthy Ins Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
A Hub International Limited Co HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
229 Andover Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Wilmington MA 01887
Phone: 978-657-5100 Fax:978-658-9185 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURERA: National Grange Mutual Ins. Co
INSURER B:
Mu ford Fsnterprises, Inc. INSURER C:
412 Foster Street INSURER D:
North Andover MA 01845
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 BEEN REDUCED BY PAID CLAIMS.
LTR NSRION
TYPE OF INSURANCE POLICY NUMBER DATEYMIWDD/Yl E PDATEY(MM/DD/TYY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE $2,000,000
A X COMMERCIAL GENERAL LIABILITY MP187672 01/01/03 01/01/04 PREMISES(Eaoccurence) $ 500,000
CLAIMS MADE X]OCCUR MED EXP(Any one person) $ 10,000
PERSONAL&ADV INJURY $2,000,000
GENERAL AGGREGATE $4,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $4,000,000
POLICY PROECT LOC
J
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
A ANY AUTO M9I87672 01/01/03 01/01/04 (Ea accident) $ 1,000,000
ALL OWNED AUTOS BODILY INJURY
X SCHEDULED AUTOS (Per person) $
X HIRED AUTOS BODILY INJURY
X NON-OWNED AUTOS (Per accident) $
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 1,000,000
A X OCCUR F-1 CLAIMSMADE CU187672 01/01/03 01/01/04 AGGREGATE $ 1,000,000
DEDUCTIBLE $
X RETENTION $10,000 $
WORKERS COMPENSATION AND X TORY LIMITS I I ER
EMPLOYEfZ LIABILITY
A ANY PROPRIETOR/PARTNER/EXECUTIVE WCI 8 7 6 7 2 01/U 1/U 3 01/01/04 E.L.EACH ACCIDENT $10 0 0 0 0
OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 100000
If yes,describe under
SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT 1 $ 500000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Septic tank service
CERTIFICATE HOLDER CANCELLATION
TOWN-20 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
Town of No. Andover NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
Town Hall IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
120 Main Street
Andover MA 01845 REPRESENTATIVES.
AUTHORIZED RESENTATIVE
ACORD 25(2001/08) C ACORD WRPORATION 198