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Home My WebLink AboutApplication and WC 84/87/19 15:88:15 1-055-093-4357 -> 500760347 The Hartford Page 881 ......t r . .,..: THE `, 14ARTVORO The Hartford Fax Cover Page RE: YANKEE CRAFTERS INC Fax Number: 508-764-3472 From: The Hartford Business Service Center Date: 4/7/2019 3:07:39 PM Subject: Total Pages: 4 PRIVILEDGED AND CONFIDENTIAL: This electronic communication, including attachments, is for the exclusive use of addressee and may contain proprietary, confidential and/or privileged information, If you are not the intended recipient, any use, copy,disclosure, dissemination or distribution is strictly prohibited. If you are not the intended recipient, please notity sender imrnediately by phone,destroy this communication and all copies. — �_ 04/07/19 15:00:Z4 1-055-093-4357 -> 500760347 The Hartford Page 003 44 4 THE HARTFORD BUSINESS SERVICE CENTER THE 3600 WISEMAN BLVD HARTFORD SAN ANTONIO TX 78251 April 7, 2019 Town Of Yarmouth Health Department Alto:Bruce Murphy 114l3 ROUTE 25 SOUTH YARMOUTH MA 02654-4163 Account Information: 14;3 Contact Us Policy Holder Details : 1 YANKEE CRAFTERS INC 71:1 Business Service Center Business Hours: Monday- Friday (7AM-7PM Central Standard Time) Phone: (877)287-1312 Fax: (888)443-6112 Email: auencv.servicesp.thehartford.com Website: httpsilbusIness.thehartford.com Enclosed please find a for the above referenced Policyholder. Please contact us if you have any questions or concerns. Sincerely, Your Hartford Service Team WILTR005 • 04/07/19 15:H13:34 1-B55-B93-4357 -> 500760347 The Hartford Page 094 ✓ ac L':: DATE trAM7DDIVYYY) CERTIFICATE OF LIABILITY INSURANCE 04/07/2019 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 A CONTRACT BETWEEN THE ISSUING INSURER(S).AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: It the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. It SUBROGATIONIS WAIVED, subject to the terms arid conditions of the policy, certain policies may require an endorsement,A statement on this certificate does not corder rights to the certificate holder in lieu of such endorsemertt s►w NrlODUCEII CONTACT NAME: PAYCHE)(INSURANCE AGENCY INC - PHONE. (877)287-1312 --Tax (BaB)443-B112 766210705 1Ar4 Nn.EAL): �1A/C,No) 150 SAWGRASS DRIVE EMAIL ADDRESS: ROCHESTER NY14620 INSURER(S)AFFORDING COVERAGE NAIL; INSURER A The Twin City Fire Insurance Company 2945 INSURED....:..,........._M_...._....�.,_ _.,..._,,..._.,__.._.......,,_,.,,...._..__ INSURkR b;_.....,�..._,..-.. __.,�._...., _...,,.,..__.M.....,.,.....,_.„., _..__...mu_,,,..,_.,.._.,....._,. YANKEE CRAFTERS INC INSURER C: PO BOX 2,..)6 �_ .w,,. _._ „„„ SOUTH YARMOUTH MA 02054-02415 IN$URk':R U INSURER F: INSURERF__......_..__._.-......._._,.,.,.,.,.,. �.__..._„_„ ._._.,......, _M._.....,.M.. .....,.,..._ ,.,...... COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INOICATED.NOTYMTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER.DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SFIOYIIN MAY NAVE SEEN REDUCED BY PAID CLAIMS. N ---1-7P-E-0-F.INSURANCE.._.- .,.-^• C SUER POLICY NUMBER -riCN-ICYER FOt.K:Y ERF M.•••.••:. �••..LIMITS LTR INSR WVD LMM/DDIYYYYI IMMI0D Y YYY] :%CIMMEREIAL GENERAL LIAFILFT Y 6:A:::Fi r;C::;;UNRf.-NGf:; 1r:LAlh5-MALE C1CC:v;I 'UAW!'i��fi*SIT ..,� II PREMISE;;[Ea nr„ rngr,iS MED EXP(Any(Irn prrr,pr•.) I C°ii;iCrNAI i Al'.%V,NJ�l�Y' GEM.AGGREGATE LIMIT APPLIES P'k DF.rik'iPAIADC:RG:C1A'I E POLICY IL".T.I PROr/lJ i CC)M ison AGt .ry—^^ 9jI 1hCT :-....I ' Ti c AUTOMOBILE LIABILITY Cs.F.APINEF)$INr+LE LIMIT FL;nrxrx:Mnrd)_ _ ANv AUTO BODILY INJJrtI(dor rxvF;xr)___..— .,.,,.,..ALL CANNED...,..,„..,. ;:c";W(,3f,-',C1 ».,_,:.........., :,.... ... .:._.........«..,.,,„.... .. A:UrOft Alar) POI)ILY IN;IIRY(IN':acrxb:•)1i w..,„HIRED _.,,.:,., IJC:N-OWNEDPr(01'LDil'"Vr,::AI�AACL._.. .,,...,.,„.��.,,.„..,,.,...,.—,,._.. ro$ OS UMBRELLA LIAR OCCUR E-A t1 r,C URRENr r. ..,.,.. EXCESS HA ta ,«.:.,. C=AIMS .., ....�.., „..,.„,.,., A MADE? r,;(; Fr1ATE RFI'ENr'IUN$ WORKERS COMPENSATION x f•'E3a. OTlb. AND EMPLOYERS'LIABILITY . , ;tA��l'1'F ER I4 M1f� YIN r.L FACIA ACCIDENT $100.000 A I aor>RII r°Rlf'ARINIER/E'CECUTIVE NEA 75 WEG NZIO61 05106%1019 05106!2020 a-l.Ic.ERIMEMBER EXCIA1 ,ED? E,L,DISEASE•FA EMPLOY 5100,000 Mantlltory In NH) -- .—..--- --- If yqy,Aa:vltxa 0n1Cr F I. DISEASE-.01_1i Y I!MIT $500,000 CLIC]RIPTION OrC1PERATIDMA DESCRIPTION OF OPERA 7/0/./.5 LQCATIQN.S/VEHICLES(ACORD 101 Auditioned Ramarlc5 ScAAdtiIa,may be AltactleYl re room WHca IF rAgti(ratl) Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION Town Ot Yarmouth Health Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED AttnBruce Murphy BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED 1146 ROUTE 28 IN ACCORDANCE WITH THE POLICY PROVISIONS. _ .. SOUTH YARMOUTH MA 02664-4463 AUTHORIZED REPRESENTATIVE 1 teem...).)a.y ED 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD M/07/19 15:88:59 1-855-893-4357 -> 508760347 The Hartford Page 065 AGENCY CUSTOMER ID: { LOC#: .._,_...�...�.,. ,,... ADDITIONAL REMARKS SCHEDULE Page 2_ of 2 AGENCY NAMED INSURED PAYCHEX INSURANCE AGENCY INC YANKEE CRAFTERS INC POLICY NUMBEF PO BOX 296 SEE ACORD 25 SOUTH YARMOUTH MA 02664-0296 CARRIER Na1C CCOC SEE ACORD 25 EFFECTIvE DATE;SEE ACORD 25 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM FORM NUMBER: ACORD 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE • Brian M. Heaslip Asst. Health Agent ACORD 101 (2014101) Q 2014 ACORD CORPORATION.All rights reserved, The ACORD name and logo are registered marks of ACORD