Finance Committee - Agenda - 11/2/2016 - P91
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CERTIFICATE OF LIABILITY INSURANCE
RARRMOT+01
JHOGAN
DATE {MGUODAYYY}
Sf25/2015
BELOW.
REPRESENTATIVE OR PROOUCER, AND THE CERTIFICATE HOLDER.
THIS CERTIFICATE JS ISSUED AS A MATTER OF INFORISATION ONLY AND COMFERS WO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES HOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
THIS CERTIFICATE OF INSURANCE DOES MOT CONSTITUTE A CONTRACT BETWEER THE ISSUING INSURER(S) AUTHORIZED
certificate holder in fiau of such andorsemeni{s}.
IMPORTANT: if the certificste holder is an ADDITIONAL INSURED, the policy(ies) muxt be endorsed. if SUBROGATION i WAIVED, aubjeci to
the terms and conditions of ite salicy, certain policies may require an endorsement. A statement on this custificaie does not coniar rights to tha
PRODUCER CONTACT
{a4 Gould Stuet Sue 1 tbo Bee e 78D 455-0700 [ ie, war (781) 249-8976
Needham, MA aponess; Cartificates@roblininsurance.com
mSURER(S) AFFORDING COVERACE HAIG a
ieunzr a: Associated Inland Marine
INSURED INGURER 8:
orl Company INSURER C:
P.0.Box 912 noe
Worcester, MA 01873-0912 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED &y PAID CLAIMS.
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WATH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED SY THE POLICIES DESCRIBED HEREIN [S SUBJECT TO ALL THE TERMS,
Lin TYPES OF INSURANCE aes hyp POLICY NUMER canoer | } deamon i] hela
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $
VERWAGE TC RERTED
CLAIMS-MADE [] OCCUR FRELPSEG [Emoceurmncs) | &
poo MED EXP (Any ony person} 5
|__J eee PERSONAL SADVIAUURY | §
| GENT, AGGREGATE UMIT APPLES PER: GENERAL AGGREGATE &
|} POUCY [_) eS JEST [| LOG PROQUGTS -cOMPIOP AGG | 5
OTHER: $
ALTOROGILE LIABILITY COMBED SINGLE Liar Ts
ANY AUTO BODILY IRUURY (Per personj |<
| | ALL OWNED SCHEDULED
|__| auTos AUTOS BODALY INJURY {Per accident} $
PROSERTY DEAGE
HIRED AUTOS AUTOS (Por reer waa £
$s
UMBRELLA LAS occur EACH OCCURRENCE $
EXCES# LAS CLAIMS-MADE AGGREGATE 3
veo | _{RerenTions 3
WORKERS COMPENSATION 7 | PS TH
AND EMPLOYERS’ LIABILITY wu % | Fire LR
AL [ANY PROPRIETORIPARTNERIEXECLITIVE D6 1B82075A OV012015 | 01/082016 | gt each aceipenr $ 500,000
OFFICERAIEMBER EXCLUDEG? []nea
Btsndetory a Ri) EL DISEASE: EAEM $ 500,000)
OLSSON OF O OF OPERATIONS nsiow EL DISEASE -POUGY UMIT 1 $ §06,000,
lissued as evidence of Insurance.
DESCRIPTION OF OPERATIONS | LOCATIONS (VEHICLES (ACORO 181, Aciittianal Ramat Schedule. may de 2itached # mere space te. required)
§0 Temple Place, 6th Floor
Boston, MA 02111
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPMRATION DATE THEREOF, NOTICE WILL BE DELIVERED iN
Mstropotitan Area Planning Council ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZES REPRESENTANVE
Foi Kotte
}
ACORD 25 (2074/01)
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The ACORD name and logo ara ragistared marks of ACORD
