HomeMy WebLinkAboutCertificate of Insurance (7)
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PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
I AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
I LUPKE-RICE-CLANCY ASSOCIATES CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVER.
I P.O. Box 11309 AGE AFFORDED BY THE POLICIES BELOW.
I Fort Wayne, IN 46857 COMPANIES AFFORDING COVERA9EM______.._._,
I COMPANY
I A St. Paul Mercur Insurance Co.
I INSURED COMPANY
I USA TRACK & FIELD AND B St. Paul Indemnit Ins. Co.
THE ATHLETICS CONGRESS OF THE COMPANY
USA, INC. C
One Hoosier Dome, Suite 140 ~"~-''',.~~~~~~-~,-..,--~~~~._.'~-~~~'~..,,.,._,.-
Indianapolis, IN 46225 COMPANY
D
I COVERAGES
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.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE (MM/DDIYY) DATE (MMIDD/YV)
GENERAL LIABILITY GENERAL AGGREGATE $ 2 000 000
A X COMMERCIAL GENERAL LIABILITY eKO 1301 310 1 2/31 /94 12/31/95 PRODUCTS-COMP/OP AGG. $ 2 000 000
CLAIMS MADE 0 OCCUR ~'. ~ _~~~~~~_~.'_.,."~~'" ~_,._,. ~~~,_.,~.2,,_::::"":::""_,_~_~
PERSONAL & ADV INJURY $ 1 000 000
OWNER'S & CONT PROT EACH OCCURRENCE $ 1,000,000
X LIABILITY ARISING OUT OF FIRE DAMAGE (Any onG fire) $ 50 000
ATHLETIC PARTICIPATION MED EXP (Any ono person) $ 5000
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT $
A ANY AUTO
ALL OWNED AUTOS BODILY INJURY
(Per Person) $
SCHEDULED AUTOS
HIRED AUTOS BODILY INJURY
$
NON-OWNED AUTOS (Per accidenf)
--,-.,,~-~~
PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONLY.. EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $ 1 000 000
B X UMBRELLA FORM 513T83695 12/31 /94 12/31/95 AGGREGATE $ 1 000 000
OTHER THAN UMBRELLA FORM $
WORKER'S COMPENSATION AND STATUTORY LIMITS
EMPLOYERS' LIABILITY EACH ACCIDENT $
INCL DISEASE POLICY LIMIT $
EXCL DISEASE - EACH EMPLOYEE $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/SPECIAL ITEMS
EVENT: Bozeman Recreation Dept. & McDonald's Children's Run SANCTION NO. 95-RR16 DATE:
August 5, 1995. Certificate Holder is additional insured for this sanctioned event.
Cr:Fl'tIFICA'J"S<HOtDe;A' CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of Bozeman DEAVOR TO MAIL
Attn: Robin Sullivan
P.O. Box 640
Bozeman, MT 59771
PO RATION 1993