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HomeMy WebLinkAboutGreenport School/CofLACORD .. CERTIFICATE OF LIABILITY INSURANCE I JAN 605 TH S CERT,F CATE ,S SSUED AS A MATER OF .FORMAT,ON PRODUCER ROY H REEVE AGENCY, INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR PO BOX 54. 13400 MAIN RD. ALTER THE COVERAGE AFFORDED BY THE FOLIClES BELOW. MATTITUCK NY 11952 INSURERS AFFORDING COVERAGE NAIC # iNSURER'~: American Alternative Insurance Co. INSURED TOWN OF SOUTHOLD INSURER B: American Alternative Insurance Company CIO SOUTHOLD TOWN HALL INSU~ER~C~ P.O. BOX 1179 iNSURER D' SOUTHOLD NY 1t971 iNSURER E: COVERAGES ~ THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOT~NITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISBUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATELIM[I-S SHOWN MAY HAVE EIEEN REDUCED BY PAID CLAIMS. ~T. ~.SRC $ 1,000,000 GENERAL LIABILITY 01-A2-RL-0000022'00 JAN I 05 JAN I 06 EACH OCCURRENCE -- DA~4AGE TO RENTED $ 300,000 EXCEBSlIJMBRELLALIABILITY 60A2UB000057701 JAN 1 05 JAN '~ 96 EACH OCCURRENCE 10,000,000 X~ OCCUR [] CLAIMS MADE AGGREGATE $ 10,000,000 B $ )THER: DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESlEXCLUSlONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER IS LISTED AS ADDITIONAL INSURED WITH RESPECT TO GENERAL LIABILITY FOR THE FOLLOWING: USE OF GYNASIUMICAFETERIA FOR AEROBICS ON MONDAYS & THURSDAYS THROUGH JUNE 23, 2005, 7:00 PM - 9:15 PM, EXCEPT JANUARY 17, :EBRUARY 21 & 24, APRIL 25 & 28, MAY 30, JUNE 2,6,9, & 13 CAN~ ~ ATION CERTIFICATE HOLDER ;HOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT GREENPORT UNION FREE SCHOOL DISTRICT 720 FRONT STREET AUTHORIZEDREPRESENTATIVE ~~~v~ GREENPORT, NEW YORK 11944 Attention: .... © ACORD CORPORATION 1988 ACORD 25 (2001108) Certificate # 5124 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 #5036 DATE (MM/DD/YYYY) · ACORD CERTIFICATE OF LIABILITY INSURANCE JAN606 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 MATI'ITUCK 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 INSURERD: INSURER E. COVERAGES I-HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ~.NY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TOWHICH THIS CERTIFICATE MAY BE ISSUED OR ~IAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH ~OLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSF ADD[ TYPE OF INSURANCE POLICY NUMBER POLiCy EFFECTIVE pOLICy EXPIRATION LIMITS _TR INSR[ DATE {MM~DD/YY} DA'rE IMMIDD/YY~ GENERAL LIABILITY 01 -A2-RL-O000022-00 JAN I 06 JAN 1 06 EACH OCCURRENCE 1,000,000 X COMMERCIALGENERAL LU~BILIT DAMAGE TMRENTE~3 300,000 CLAIMS MADE OCCUR MED EXP (Any one person) 5,000 A XI DEDUCTIBLE - $50.000. SIR PERSONAL & ADV INJURY 1,000,000 GENERAL AGGREGATE 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS*COMPIOP AGO 2,000,000 AUTO ONLY ~G~ $ EXCESS I UMBRELLA LIABILITY 60A2UB000057701 JAN t 06 JAN I 06 EACH OCCURRENCE 10,000,000 X OCCUR ~ CLAIMS ~,RDE t0,000,000 B s DESCRIPTION OF OPERATIONSlLOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER IS LISTED AS ADDITIONAL INSURED WITH RESPECT TO GENERAL LIABILITY FOR THE FOLLOWING: USE OF GYNASlUMICAFETERIA FOR AEROBICS ON MONDAYS & THURSDAYS THROUGH JUNE 23, 2006, 7:00 PM - 9:15 PM, EXCEPT JANUARY 17, FEBRUARY 21 & 24, APRIL 25 & 28, MAY 30, JUNE 2,6,9, & 13 CERTIFICATE HOLDER __ CANCELLATION GREENPORT UNION FREE SCHOOL DISTRICT 720 FRONT STREET GREENPORT, NEW YORK 11944 Attention: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN 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 iNSURER. 1TS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ~h~~~ ACORD 25 (2001108) Certificate # 5124 © 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 #5124 DATE (MM/DD/YYYYI ACORD CERTIFICATE OF LIABILITY INSURANCE 01/t912006 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 $OUTHOLD TOWN HALL P.O. BOX 1179 INSURER C' $OUTHOLD NY 11971 INSURERD INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A~OVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WJTH RESPECT TOWHICH THIS CERTIFICATE MAY SE 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 NSR ADD'I TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLIcY EXpIRA'~ON GENERAL LIABILITY 01 -A2-RL-0000022-00 01101/05 01101106 EACH OCCURRENCE $ 1,000,000 I CLAIMS MADE [~ MED EXP (Any one person) $ 6,000 A __X DEDUCTIBLE - $50,00[3 SIR PERSONAL & ADVINJURY $ 1,000,000 ~ POLICY ITJEcTPRO' ~ LOC PRODUCTS-COMP/OPAGG. $ 2,000,000 EXCESS / UMBRELLA LIABILITY 60A2UB000057701 01/0t/05 01/0tl06 EACH OCCURRENCE X I OCCUR [] CLAIMS MADE t0,000,000 AGGREGATE $ 10,000,000 B $ X RETENTION $ 10,000 3PE¢IAL PROVISIONS below E.L DISEASE-POLICY LIMIT $ OTHER: DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLESIEXCLUSlONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER IS LISTED AS ADDITIONAL INSURED WITH RESPECT TO GENERAL LIABILITY FOR THE FOLLOWING: USE OF GYNASIUMICAFETERIA FOR AEROBICS ON MONDAYS & THURSDAYS THROUGH JUNE 23, 2005, 7:00 PM - 9:15 PM, EXCEPT JANUARY 17, FEBRUARY 21 & 24, APRIL 25 & 28, MAY 30, JUNE 2,6,7,9, & 13,14 I~.FRTIPJI~&,T[;= bl('tl rtl;;D .............. GREENPORT UNION FREE SCHOOL DISTRICT 720 FRONT STREET GREENPORT, NEW YORK 11944 Attention: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATrON DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, EUTFAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001108) Certificate # 5206 © 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 cedificate 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 #5206