HomeMy WebLinkAboutCertificate of Insurance (6)
At.ttllltl,__:II:lIi<li:li1i1i!.;II,.:Sij!liicE 004455, .. ~ATE (MM/DD/YV)
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PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
LUPKE-RICE-CLANCY ASSOCIATES CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVER-
P.O. Box 11309 AGE AFFORDED BY THE POLICIES BELOW.
Fort Wayne, IN 46857 COMPANIES ~..fFORJ?t~q CQYERAG~___~__,__
COMPANY
A St. Paul Mercur Insurance Co.
--'~,-
INSURED COMPANY
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
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/DD/YY) DATE (MM/DD/YY)
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 PERSONAL & ADV INJURY $ 1 000 000
OWNER'S & CONT PROT eACH OGCURR~NCF $ 1 000 000
X liABILITY ARISING OUT OF FIRE DAMAGE (Anyone fire) $ 50 000
ATHLETIC PARTICIPATION MED EXP (Anyone person) $ 5000
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT $
A ANY AUTO
ALL OWNED AUTOS BODILY INJURY
(Per Person) $
SCHEDULED AUTOS
.-.-.-..---.----------.-
HIRED AUTOS BODILY INJURY
(Pm "ceident) $
NON OWNED AUTOS
-"- ------.--.---... . .._.._'~,--_.
---- PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
--.,..,
ANY AUTO OTHER THAN AUTO ONLY:
'0."""
EACH ACCIDENT $
~'.'---
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $ 1 000"000___
B X UMBRELLA FORM 513TB3695 1 2/31 /94 12/31/95 AGGREGATE $ 1 OOO..,QOO ____
OTHER THAN UMBRELLA FORM $
WORKER'S COMPENSATION AND STATUTORY LIMITS
EMPLOYERS' LIABILITY EACH ACCIDENT $
INCL DISEASE - POLICY LIMIT $
-~..~~-~----,.,_.- -..--......-... . -- ---'-""~"..' ,
EXCL DISEASE .. EACH EMPLOYE~ $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
EVENT: First Security Bank Sweet Pea Run SANCTrON NO. 95-RR15 DATE: August 5, 1995
Certificate Holder is additional insured for this sanctioned event.
CANCEI..LA.'1'ION
City of Bozeman ENDEAVOR TO MAIL
Attn: Robin Sullivan
P.O. Box 640
Bozeman, MT 59771
ORPORATION 1993