HomeMy WebLinkAboutCorazzini Cert of LiabilityLITY INSURANCE 01/24/2005
THIS CERTIFICATE IS ISSUED AS A MAI'rER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
fi HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
iNSURERS AFFORDING COVERAGE NAIC #
INSURERA: GENERAL CASUALTY CO. OF WI
INSURER B:
INSURER C: ZURICH
INSURER D:
INSURER E: ~
ACORD CERTIFICATE OF LIABI
ROY H REEVE AGENCY, INC. /~ [' ~, -.
PO BOX 54, 13400 MAIN RD.
MATTITUCK NY 11952
JA/V
INSURED
CORAZZINI ASPHALT INC ETAL ~'- _
COX LANE PO BOX 1281 .
CUTCHOGUE NY 11935
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW RAVE BEEN ISSUED TO THE ~NSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING
ANY REOUIREMENT 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 PA[{) CLAIMS
LTR INSR£ $ 1,000,000
GENERAL LIABILITY CC10395378 02107105 02/07/06 EACH OCCURRENCE
DAMAGE TO RENTED $ 50,000
MED EXP (Any one person) $ 5,000
I CLAIMS rv~DE{~ OCCUR
PERSONAL & ADV iNJURY $ 1,000,000
A __ GENERAL AGGREGATE 2,000,000
~'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMP/DP AGG 2,000,000
~ POLICY ~ PRO- [~LOC
JECT
AUTOMOBILE LIABtLII¥ CBA0395378 02/07105 02/07106 COMBINED SINGLE LIMIT 1,000,000
(Ea ec~dent)
ALL OWNED AUTOS (Per person} $
A _iiRED AUTOS =er accident)
EXCESS t UMBRELLA LIABILITY CCU0390378 02/07/05 02107106 E~CH OCCURRENCE 5,000,000
X~ OCCUR [] CLAIMS MADE AGGREGATE 9,000,000
A $
X~ DEDUCTIBLE
RETENTION S 10,000 WC ST^TU-
WOERERS COMPENSATION AND CWC0395378 02/07105 02/07106
EMPLOYERS' LIABILITY E L EACH ACCIDENT $ 100,000
A A"~ PROPRIETOPJ~ARTNEP~E~ECUTIVE E L. DISEASE-LA EMPLOYEE $ t 00,000
E L DISEASE-POLICY LIMIT $ 000,000
OTHER: DISABILITY INSURANCE 1722257-00t 01/01109 0110tl06 DISABILITY .'..~;;=FITS COVERAGE
C
DESCRIPTION OF OPERATiONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORS=~-hTI SPECIAL PROVISIONS
TOWN OF SOUTHOLD, C&S ENGINEERS INC, THE FEDERAL AVIATION ADMINISTRATION, AND THE NEW YORK STATE DEPARTMENT OF
TRANSPORTATION IS INCLUDED AS AN ADDITIONAL INSURED ON AUTO AND GENERAL LIABILITY POLICIES
AlP PROJECT NO. 3.36.0029-09-02(C}
~YSDOT PROJECT NO. 0913.09 (C)
CERTIFICATE HOLDER CANCELLATION
TOWN OF SOUTHOLD
PO BOX 1t79 AUTHORIZED REPRESENTATIVE
SOUTHOLD NY 11971
Attention: ~ A~Rr~ CORPORATION t988
ACORO 25 (2001 ~08) Certificate # 5229
IMPORTANT
Ifthe 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 #5229