ACORYY DATE(MM/DDIYYYY)
ee CERTIFICATE OF LIABILITY INSURANCE ov/2ar2022
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 OOES 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 L
SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this 2
certificate does not confer rights to the certificate holder in lieu of such endorsement(s). €
PRODUCER Come 3
Aon Risk Services Central, Inc. aa FAX by
Omaha NE Office (WC.No.exy: (402) 697-1400 FAX a}, (402) 697-0017 3
17807 Burke Street E-MAIL =
suite 401
Omaha NE 68118 USA
INSURER(S) AFFORDING COVERAGE NAIC #
INSURED A Indian Harbor Insurance Company 36940
Musco Sports Lighting, LLC INSURER B: Travelers Property Cas Co of America 25674
c/o Musco Corporation
100 1st Ave w INSURER C; Sentry Casualty Company 28460
Oskaloosa IA 52577 USA INSURER D: Sentry Insurance Company 24988
INSURER E:
INSURER F
COVERAGES CERTIFICATE NUMBER: 570094632598 REVISION NUMBER:
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. Limits shown are as requested
ey TYPE OF INSURANCE ausp| We. POLICY NUMBER pouicy err rote exe LIMITS
D | Xx | COMMERCIAL GENERAL LIABILITY Y 9016877004 07/01/2022 07/ O1/ 20231 each occuRRENCE $1,000,000
DAMAGE TO RENTED
| CLAIMS-MADE [ x J occur PREMISES [En 'occtifrence) $300,000
MED EXP (Any one person} $10 ’ 000
PERSONAL & ADV INJURY $1,000,000} ,
‘ee an
GEN’L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000;
1 oO
POLICY ne toc PRODUCTS - COMP/OP AGG $2,000,000] ©
——~T oa
OTHER 3
© | auTomosiLe LABILITY 90 16877 003 07/01/2022| 07/01/2023) ComBINED SINGLE LIMIT $1,000,000 °
cident ' :
x | ANY AUTO BODILY INJURY ( Per person) °
| OWNED | SCHEOULED BODILY INJURY (Per accident) =
[7 AvTOs ONLY AUTOS PROPERTY DAMAGE s
x | HIRED AUTOS x | NON-OWNED R 8
L—4 onty AUTOS ONLY |_(Per accident) =
| =e
+ ao
B | x | umBRELLALIAg x | occur CUP3S63336022NF 07/01/2022] 07/01/2023] cach occuRRENCE $10,000,000] ©
r | EXCESS LIAB || ctams-mane AGGREGATE $10,000, 000)
DED | x [retENTION $10,000
C | WORKERS COMPENSATION AND 9016877001 07/01/2022] 07/01/2023) y | Per statuTE jor
EMPLOYERS’ LIABILITY YIN AOS =
c | Grrceenenserexcuvenr = [NT wa| 19016877002 07/01/2022}07/01/2023]£+ EACHACCHENT $7,000,000
(Mandatory In NH) AZ, WI EL DISEASE-EA EMPLOYEE $1,000,000
DESCRIPTION oe ‘OPERATIONS below EL DISEASE-POLICY LIMIT $1,000,000
a | Archit&Eng Prof CE0742113902 07/01/2022] 07/01/2023| Aggregate $5,000,000
Claims -Made SIR $250,000) ==
SIR applies per policy terms & condi Each Claim $5,000,000] iam
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Remarks may be if more space is required) =
RE: Musco Project 208204 - Labine Park Softball. City of Nashua is included as Additional Insured in accordance with the =
policy provisions of the General tiability policy. ma
=
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ad
CERTIFICATE HOLDER CANCELLATION =~
SHOULD ANY OF THE DESCRIBED POLICIES BE CANCELLED BEFORE THE 5
EXPIRATION DATE THEREOF, NOTICE WILL @E OELIVERED IN ACCORDANCE WITH THE a
POLICY PROVISIONS. acs
city of Nashua AUTHORIZED REPRESENTATIVE ras
229 Main Street es
Nashua NH 03060 USA > TZ ra
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ACORD 25 (2016/03)
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