HomeMy WebLinkAboutCERT OF LIABILITY INSURANCE ACORDT. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
PRODUCER (319)352-2880 FAX: (319)352-2075 THIS CERTIFICATE IS ISSUED AS A MATTER OIF INFORMATION
First Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
300 E Bremer Ave HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 269
Waverly IA 50677 INSURERS AFFORDING COVERAGE
INSURED NAIC#
INSURER A:Grinnell Mutual 14117
Air Systems Heating & Cooling, Inc.
INSURER 8:
915 Center Street
INSURER C:
INSURER D:
Cedar Falls IA 50613
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.
INSR ADD'L
LTR INSRD TYPE OF INSURANCE POLICY NUMBER PDATE(MM/DD/YY)PDATE(MM/DDN�N LIMITS
GENERAL LIABILITY
EACH OCCURRENCE $ 1,000,000
X I COMMERCIA.!_GENERAL LIABILITY DAMAGE TO RENTED _
PREMISES(Ea occurrence) ,$ 500,000
A CLAIMS MADE X OCCUR 5000023875 8/1/2007 8/1/2008 (
MED EXP Any one person) $ 5,000
PERSONAL&ADVINJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRO
X POLICY n LOC PRODUCTS-COMP/OP AGG $ 1,000,000
AUTOMOBILE LIABILITY
ANY AUTO COMBINED SINGLE LIMIT
(Ea accident) $ 500,000
A ALL OWNED AUTOS 0000307127 8/1/2007 8/1/2008
BODILY INJURY
X SCHEDULED AUTOS (Per person) $
X HIRED AUTOS
BODILY INJURY
X NON-OWNED AUTOS (Per accident) $
PROPERTY MAGE $
(Per accident)DA
GARAGE LIABILITY
AUTO ONLY-EA ACCIDENT $
ANY AUTO
OTHER EA ACC $
AUTO ONLY:THAN
AGG $
EXCESS/UMBRELLA LIABILITY
FACH OCCURRENCE $ 5,000,000
X OCCUR CLAIMS MADE
AGGREGATE _ $ 5,000,000
A DEDUCTIBLE 0000307184 8/1/2007 8/1/2008 $
$
X RETENTION $10,000 -_,
$
A I WORKERS COMPENSATION AND I . WCAM -, OR-
I1 _EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000
OFFICER/MEMBEREXCLUDED? 00000307134 8/1/2007 8/1/2008 If yes,describe under E.L.DISEASE-EA EMPLOYEE$ 500,000
SPECIAL PROVISIONS below
OTHER
E.L.DISEASE-POLICY LIMIT $ 500,000
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Project: 2008 Riverfront Stadium Kitchen Hood and Exhaust Fan, 850 Park Rd., Waterloo, IA 50703
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of Waterloo, Iowa EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
Waterloo Leisured Services Commission 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT
Attn: Rick Curran
1101 Campbell Ave. FAILURE TO DO SO SHALL IMPOS NO OBLIGATION OR LIABILITY OF ANY KIN UPON THE
Waterloo, IA 50701 INSURER,ITS AGENTS OR REPRE: TA IVES.
AUTHORIZED REPRESENTATIVE I
Darcy Coonradt lbw°I
,,I ACORD 25(2001/08) KCiTh-A-CL___J
CORD CORPORATION 1988
INS025(0108).08a
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IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this
certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing
insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively
amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25(2001/08)
INS025(otos).osa Page 2 of 2