HomeMy WebLinkAboutMiscellaneous - Exception (437)23/2016
12:08 PM FROM: 9782241040
TO: +19786889542
ZO LOB RO-01
P. 1
CPHELAN
CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDD/YYYY)
2/23/2016
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(les) must be endorsed. If SUBROGATION IS WAIVED, 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
AP Intego Insurance Group, LLC
1601 TraPelo Rd
Suite 174
Waltham, MA 02451
CONTACT
NAME: Linda ROetS
PHONE FAX
/c o ext : (888) 289-2939 A/c No): (888) 298-2988
E-MAIL inte Cservice a O.com
ADDRESS: @ p g
INSURER(S) AFFORDING COVERAGE NAIC #
INSURERA:The Hartford' 10456
PREMISES Ea occurrence $
INSURED
INSURER B
INSURER C:
Zolotas Bros Inc
INSURER D:
515 Lowell Street
Peabody, MA 01960
INSURER E
INSURER F:
LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
HIRED AUTOS AUTOS
GUVtKAGE5 CERTIFICATE NUMBER' RR\/ISIAN NIIMRGR•
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 CONTRACTOR 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.
INSR
LTR
TYPE OF INSURANCE
ADDL
INSD
SUBR
WVD
POLICY NUMBER
POLICY EFF
MMIDD/YYYY
POLICY EXP
MMIDDNYYY
LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
EACH OCCURRENCE $
PREMISES Ea occurrence $
MED EXP (Any one person) $
PER SON AL& ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY JECTPRO-
F—] LOC
OTHER:
GENERAL AGGREGATE $
PRODUCTS -COMP/OP AGG $
$
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
HIRED AUTOS AUTOS
COMBINED SINGLE LIMIT $
a accident
BODILY INJURY (Per person) $
BODILY INJURY Per accident $
( )
PROPERTY DAMAGE
er accident $
UMBRELLA LIAR
EXCESSLIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE $
AGGREGATE $
DED RETENTION $
$
A
WORKERS COMPENSATION
ANDEMPLOYERS'LIABILITY Y!N
ANY PROPRIETORIPARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? ❑
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N /A
76WEGGD6056
05/01/2015
05/01/2016
PER OTH-
STATUTE X ER
E.EACHACCIDENT $ 500,00
L
E.LDISEASE- EAEMPLOYEE $ 500,00
F.L. DISEASE - POLICY LIM IT $ 500,00
DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Town of North Andover
1600 Osgood Street
Building 20, Suite 2035
North Andover, MA 01845
VH INVGLLA I IV tV
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
cJ 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD