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HomeMy WebLinkAboutWorkers Comp 91725 arm CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 09/18/24 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 NAME:CONTACT PAUL SCHLEGEL Schlegel&Schlegel Ins Brokers,Inc. (NC. Ext): 508-771-8381 FAX No): 508-771-0663 34 Main StreetE-MAIL West Yarmouth,MA 02673 ADDRSS: schlegelinsurance@gmail.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: GUARD INSURANCE INSURED INSURER B: KINSALE INSURANCE ALPHA ENTERTAINMENT GROUP LLC INSURER C: HOSPITALITY MUTUAL DBA MUSIC ROOM INSURER D: 541 MAIN ST ROUTE 28 WEST YARMOUTH,MA 02673 INSURER E: INSURER F: 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 INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BEISSU✓-8OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AN(S CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I EFF POLICY EXP LTR TYPE OF INSURANCE ,INSD sWVO POLICY NUMBER (MM/DD POLICYBR /YYYY) (MM/DO/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED ADE X PREMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 B KIN100378 09/17/24 09/17/25 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECT LOC PRODUCTS-COMP/OP AGG $ 1,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY _ AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY — AUTOS ONLY (Per accident) $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ p , EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ RKERS COMPENSATION - I PER I IOTH- AND EMPLOYERS'LIABILITY Y/N STATUTE I ER A OFFICER/MEMBOERANY EXCLUDR/EXECUTIVE NIA ALWC551752 09/14/24 09/14/25 E.L.EACH ACCIDENT $ 500,000 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 LIQUOR LIABILITY EACH OCCURENCE 250,000 C CPP2003531 . 09/17/24 09/17/25 LIMIT 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN TOWN OF YARMOUTH ACCORDANCE WITH THE POLICY PROVISIONS. 1146 ROUTE 28 - SOUTH YARMOUTH,MA 02664 AUTHORIZED REPRESENTATIyr a, . ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD