Fire Department Master Pian Neshua, NH
Appendix C: ESC] Certificate of Insurance
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ACORD CERTIFICATE OF LIABILITY INSURANCE w/r/aoie
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 DOES NOT CONSTITUTE & CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the cortificate holder is an ADDITIONAL INSURED, tha policy(iss) must ba endorsed. If SUBROGATION iS WAIVED, subject to
the terms and conditions of the policy, certaln policies may require ar endorsement. A statement on this certificate does not conter rights to the
certificste holder in tiau of such endorsemont(s).
PRODUCER ; [sate chei.ce tie Montero
Wilson-Heirgsod Asscciates “¥AX —
2930 Chad Drive (AE, Ho, Exp 541-284-5855. " (C, H9}: 541-342-3786
PO Box 1421 ADORESS. CmonteroSwhainsurance.com _ .
Eugene OR 97440-1423 Cee ER oe: 22934
—— : oe ek INSURER(S} AFFORDING COVERAGE NAIC @
INSURED | MSURERA: Philadelph
Emergency Services Consulring International
25200 Sh Parkway Avenue #3 MSURERS .SAIF Corpsrat ion,
Wilsenville OR 97070 |IWSURERC: . _ .
INSURER 0 :
MBURERE : weet ce ce ee ne ee eee eeeeeee
INSURER EF:
COVERAGES CERTIFICATE NUMBER: 1104746079 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEO TO THE INSURED NAMED ABOVE FOR THE POLICY
PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VATH RESPECT 70
WHICH THIS CERTIFICATE HAY BE ISSUED OR PAAY PERTAIN, THE INSURANCE AFFOROED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT
TO ALL THE TERMS. EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAINS
Se ee “ABOU SUBR: ~~ i axp
lites TYPE OF RSURANCE Lis POUCY HUMBER datmerin | ueonyyy, urs
| GENERAL UABASTY 1 TPHSN21 20576 vitae = [2/3/2017 | excuoccuaREnce | $3.000, 600
: i of " DAMACE TORENTEO —
%_| COMMERCIAL GENERAL UASILIFY i PREMISES {Fx ncasnence) $50,008
: i
| Stamp rape 3 ) cccur MEDEXP (Ary one geeacny | $5.6
i PERSONAL & ADV INJURY i 421,000, coo
_ GENERAL AGGREGATE 145,060,009
; GENT AGGREGATE Loan APPLIES PER
. PRODUCTS -COMP-OF AGG . g2.60%, C30
i
|
i
; i
x | paver! oRO. 406 1 | ‘s
& | AUTOMOBILE UABRATY WFHSDLIO57E BAL I2O16 pleases 37 0° COMBINED SINGLE LIMIT $1,709,098
; i (Ea seeder) te ees
ANY AUIO ' S BODAY INJURY [Pet pemeny |
\ Se ee ee ee -
_ ALL OWHEO AUTOS Y [Pet accsteaty| $
‘| scHepuLeo autos | | PROPERTY oxuaGE ‘s ~
7%) WRED AUTOS | (Per scedent :
4% | HOH-OWRED AUTOS t ne en oo
i | ! $
A ix [UMGRELLALIAB x foccua 9 | FHUBE27573 fa7172036 [1/1/2017 | EACMOCCURRENCE | $2,000,608
| | EXCESS LAB id evavaseaape! $2.500,003
DEDUCTIOLE yo i is oo
re REYENNDN $10,069 Pe | i s
f& | WORKERB COMPENSATION ° "376036 rerézone bisisaeia (x GR eTARBS x [OR
| AND EMPLOYERS: ABILITY mene ‘ ‘ TORY uMits %. ER -
Taney PROPRIETOR ARTLERERECUTIE [* : = Ed EACH ACCIOENT $2,039,008
i OFFICCAWEMDER EXCLUSED' ‘waa’ t i a
j [Mandstory in KH) Et OSEASE EA EMPLOYES OV, 9du
1 Wyes. gasenve unaet { =
i 2 SCRIPTION OF GPERATIONS pelow : : Let OISEASE- POLICY LIMIT $2,906,000
h ‘PEcfessicnal Liabilsz7 PUSH AS O97E B7ifeaeG SN i/aer? Clain 2,089, Gc0
2uLAL Agmeysre 2eOH0, 698
\
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORO 10f, Additional Remarks Schedule, if more space le required)
‘Umbrella coverage does not apply to Professional Liabilicy:
Fire Frotection and Paramedic Services Strategic Plan
CERTIFICATE HOLDER CANCELLATION
SHOULO ANY OF THE ABOVE DESCRIBED POLICIES BE CARCELLED
BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL GE DELIVERED
City of Yucarpa IN ACCORDANCE WITH THE POLICY PROVISIONS.
34272 Yucaipa 8crlevard
Yucaipa Ch 92359
AUTHORIZED REPRESENTATIVE
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© 1988-2009 ACORD CORPORATION. Ali rights reserved.
ACORD 25 {2009/09} The ACORD name and !ogo are registered marks of ACORD
ESC Emergency Services ~ oO - 4
Consulting International 2? 1 B34
