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HomeMy WebLinkAboutVillage of Grnpt/C of Liab.DATE (MM/DD/YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE iA. 1005 TM PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ROY H REEVE AGENCY, INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE PO BOX 54, 13400 MAIN RD. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR MATTITUCK NY 11952 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: American Alternative Insurance CO. TOWN OF SOUTHOLD INSURER B: American Alternative Insurance Company CIO SOUTHOLD TOWN HALL INSURER C: P.O. BOX 1179 SOUTHOLD NY 11971 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN iSSUED TO THE iNSURED NAMED ABOVE FOR THE POLICYPERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TOWHICH THIS CERTIFICATE MAY BE iSSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS GENERAl. l.lABILITY 01-A2-RL-0000022-00 JAN 1 05 JAN I 06 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED $ 300,000 I CLAIMS MAOEI~ OCCUR MED. EXP (A~y one person) $ 5,000 m X DEDUCTIBLE - $50.000 SrR PERSONAL 8. ADV iNJURY $ t,000,000 GENERAL AGGREGATE $ 3,000,000 EXCESS/UMBRELLALIABILITY 60A2UB000057701 JAN 1 05 JAN t 06 EACH OCCURRENCE $ 10,000,000 oCCUR II CLAIMS MADE AGGREGATE $ 0 B X~ DEDUCTISLE $ RETENTION $ 10,000 $ WORKERS COMPENSATION ANO I,VV~C~SvT~A~T~,U~ I I°T"ER CERTIFICATE HOLDER __ CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRFCFEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE VILLAGE OF GREENPORT INSURER. ITS AGENTS OR REPRESENTATIVES. 236 THIRD STREET ~.UTHORIZED REPRESENTATIVE GREENPORT, NY 11944 Attention: ACORD 25 (2001108) Certificate # 5146 © ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25-S (2001/08) Certificate #5146