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HomeMy WebLinkAboutMiscellaneous - Exception (344)FAMIPOO-02 cwnnnsinF CERTIFICATE, OF LIABILITY INSURANCE DATE 1 5//25/22512017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License # 1780862 HUB International New England 299 Ballardvale Street Wilmington, MA 01887 CONTACT Paula Hall NAME: PHONE FAX (A/c, No, Ext): (978) 661-6652 (ANC, No); EMAIL ADDRESS: paula.hall@hubinternational.com INSURERS AFFORDING COVERAGE NAIC # X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE n OCCUR X Blanket Add'I Ins. INSURER A: Valley Forge Insurance Company _ 20508 _ INSURED North LLC Family Pools th Inc. Family Pools N INSURER B: Safe Insurance Company 39454 INSURER C: Wesco Insurance Company 25011 EACH OCCURRENCE $ 1'000'000 70 S. Broadway INSURER D: INSURER E: Lawrence, MA 01843 INSURER F: COVFRAGFS CFDTIFIrATF NIIIMRFD• ocviclnu RurRADED. THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR NSR TYPE OF INSURANCE SD SU_BRWVD POLICY NUMBER POLICY EFF IDD POLICY EXP 1 LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE n OCCUR X Blanket Add'I Ins. 6015920803 09!1912016 09/1912017 EACH OCCURRENCE $ 1'000'000 PREM SES (E. ocu RENTED nce $ 100'000 MED EXP (Any one person $ 5'000 PERSONAL 8 ADV INJURY $ 1,000'000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JEC LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG $ 2'000'000 OTHER: B AUTOMOBILE LIABILITYO aBINED SINGLE LIMIT $ 11000,000 BODILY INJURY Perperson) $ ANY AUTO OWNEDSCHEDULED AUTOS ONLY X AUTOS 3947232 12/31/2016 12131/2017 BODILY INJURY Per accident $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLYPer _ PROPERTY DAMAGE accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE___ $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ _ $ C AND EMPLOYERS' LIIABILIT ANY PROPRIETOR/PARTNER/EXECUTIVEY N FFICERIMEMBER EXCLUDED? (Mandatory in NH) P500,000 If yes, describe under DESCRIPTION OF OPERATIONS below NIA IE.L. WWC3246415 12/31/2016 12/3112017 X STATUTE ERH E.L. EACH ACCIDENT $ 500,000 _ E.L. DISEASE - EA EMPLOYEE $ DISEASE -POLICY LIMIT $ 500,000 A Property 6015920803 09/1912016 09/19/2017 vrs limits A Repl Cost 6015920803 09/19/2016 09/1912017 $1000 ded DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Workers Compensation has Blanket Waiver of Subrogation, as required by executed contract. Re:Carl and Betsy Tenenbaum, 125 Peachtree Lane SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 120 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. North Andover, MA 01845 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All The ACORD name and logo are registered marks of ACORD