Viewing page 41 of 88
This transcription has been completed. Contact us with corrections.
10/20/95 14:55 [[image - telephone]] 203 377 8414 BURGER & BURGER 002 ACORD CERTIFICATE OF INSURANCE BP 03790 ISSUE DATE (MM/DD/YY) 10/20/95 PRODUCER UNITED INS AGENCIES INC. 2890 Main Street Stratford CT 06497 INSURED Lippincott, Inc. and Donald Lippincott ATIMS 2399 Ridge Road New Haven, Ct 06473 THIS CERTIFICATE ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY LETTER A NORTHBROOK INSURANCE CO COMPANY LETTER B COMPANY LETTER C COMPANY LETTER D COMPANY LETTER E COVERAGES 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR DATE (MM/DD/YY) DATE (MM/DD/YY) GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR. OWNER'S & CONTRACTOR'S PROT LIMITS GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG. $ PERSONAL & ADV. INJURY $ EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) $ MED. EXP. (Any one person) $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY LIMITS COMBINED SINGLE LIMIT $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM LIMITS EACH OCCURRENCE $ AGGREGATE $ WORKER'S COMPENSATIONS AND EMPLOYERS' LIABILITY STATUTORY LIMITS EACH ACCIDENT $ DISEASE - POLICY LIMIT $ DISEASE - EACH EMPLOYEE $ A OTHER INLAND MARINE FINE ARTS DEDUCTIBLE POLICY NUMBER: 78635479 POLICY EFFECTIVE DATE (MM/DD/YY) 04/30/95 POLICY EXPIRATION DATE (MM/DD/YY) 04/30/96 Limits $874,500 DEDUCTIBLE $ 1,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS CERTIFICATE HOLDER IS LOSS PAYABLE AS RESPECTS: DUCK BY TONY SMITH PRESENTLY IN THE POSSESSION OF THE INSURED. CERTIFICATE HOLDER CHRYSLER CORP., C/O ELIZABETH LETTSHEK 2615 FEATHERSTONE RD AUBURN HILLS MI 48326 CANCELATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELED 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 MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Betty Pow ACORD 25-S(7/90) ACORD CORPORATION 1990 OCT 20 '95 14:35 203 377 8414 PAGE.02
