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HomeMy WebLinkAboutApp-License-Certificates ACOR ® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYW) `..---- 11/10/2023 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: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME; Joseph Dupuis McShea Insurance Agency, Inc (NC. Est): (508)420-9011 FAX No): (sos)a2o-9o10 1645 Falmouth Road, Rt 28 BLDG D n Ess: joe@mcsheainsurance.com Centerville, MA 02632 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: The Hartford Insurance Company 11000 INSURED INSURER B: NATIONAL GRANGE MUTUAL 14788 Captain Parkers Pub, Inc. INSURER C: The Hartford Insurance Company 22357 . 688 Route 28 INSURER D: West Yarmouth, MA 02673 INSURER E: INSURER F: _ _ ___ COVERAGES CERTIFICATE NUMBER: 00000413-639799 REVISION NUMBER: 2 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXPD/ LIMITS LTR INSD WVD POLICY NUMBER fMM/DD/YYYY) (MMIDYYYY) A X COMMERCIAL GENERAL LIABILITY 08SBANX5037 04/05/2023 04/05/2024 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 1,000,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 X POLICY ECOT- LOC PRODUCTS-COMP/OP AGG $ 4,000,000 _ OTHER: $ B AUTOMOBILE LIABILITY M 1 T2388U 08/07/2023 08/07/2024 Ea aBI deD SINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY X AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY (Per accident) $ A X UMBRELLA LIAB X OCCUR 08SBANX5037 04/05/2023 04/05/2024 EACH OCCURRENCE $ 4,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 4,000,000 DED RETENTION$ $ C WORKERS COMPENSATION 08WECCM3443 04/01/2023 04/01/2024 X STATUTE OTH- ER AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 A Liquor Liability 08SBANX5037 04/05/2023 04/05/2024 Per Occurrence 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Liquor Liability is included as part of the Commercial Package policy with The Hartford limit is$1, _ _ _ I - $2,000,000 Aggregate Location Address: 688 Route 28 Yarmouth, MA H -- P T CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Yarmouth THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Buildung Department, Board of Health, Liquor ACCORDANCE WITH THE POLICY PROVISIONS. 1146 Route 28 South Yarmouth, MA 02664 AUTHORIZED REPRESENTATIVE 1 62 (JFD) ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are re ered marks of ACORD Printed by JFD on 11/10/2023 at 02:52PM o -z/dJJH / ISO