Laserfiche WebLink
Client#: 21107 DOREASS <br />DDfYYY <br />ACORD. CERTIFICATE OF LIABILITY INSURANCE D06/11JU/217 017Y) <br />5/11 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT; If the certificate holder Is an ADDITIONAL INSURED, the Pollcy(Ios) mint ba ohdnraad, ll SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement, A statement on this certificate does not confer rights to the <br />.certificate holder In lieu of such andoraement(a), <br />PRODUCER <br />Judy WoJroW®k1 _ <br />Meadowbrock, Inc,ISaglnew Agcy u4fT <br />989799.6390 N 989Saginaw Commercial Lines ;I�O)i...— — I!Yc,. } <br />Sag Box 5om lway,Wajrowsk[@meadowbrook,cori <br />P.OSaginaw, MI 48603-5889 µ 889 <br />Ilnsuronce Co20281 <br />DIrla DovERAae ...— 1a w....-. <br />INSURER A: Federal <br />lilsu Ev - .� INSURER s:American Auto Ins Co ___.._._- ....:...................-- 21849...._._ <br />Dore & Associates Contracting, Inc. -- <br />SOO Harry 8 Truman Pkwy, PA Box 146 INSURER C_I <br />INSURER D I <br />Bay City, MI 40707 <br />INSURER E ; _ --� --• . <br />1:r1llFRAr.F-Q r FrRTEFIC'ATF NLIMRFR% REVISION NUMBER! <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUVQ TO THI" INSURED NAMED ADOVE; FOn THE POLICY PEi;IOD <br />INDICATED, NOTWITHSTANDING ANY REOUIREMENT, TERM OR CONOITIONOF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />N 'g - --._., _..._._..._ ........._.. _..._.___. "-_. Rtlb 5U$p' - ...........,_—.—r <br />LT� r 'TYPE OF INSURANCE POLICY NUM4eR <br />ton, ycvA. <br />P �k Y <br />fn Mhf1�DlVYYY LIMIT& <br />a�r�w MY%. (� }..��__._ _ ._.... __ ..__.. .._.__r........_._. <br />COMMEACIALGENERALLIABILITY - - <br />-- -- EACH OCCURRENCE <br />6 <br />-CLAIMS-MADE OCCUR <br />a <br />i�RPAISCSRMN'jlnce} <br />3 <br />ME4 EXP (Any one paraool <br />3 <br />, .....R: _.;...... <br />- PERSONAL 6 ADV INJURY <br />S <br />GEN'L AGGREGATE LIMIT APPLIES PE <br />gENERALAdOREdATG <br />b <br />_ <br />PRO,. <br />POLICY JECT .� LOC <br />- <br />PRODUCTS-COMPIOP AGO <br />»..__.....�..._...-..._.. <br />B <br />AUTOMOBILE <br />LIABILITY <br />MXAS0325378 <br />0413012017 <br />04/30/20101e`Iitt�iFic7r <br />l"c}Li%tn+iV <br />BODILYIWURY(Perparson) <br />IS <br />X <br />ANY AUTO <br />.,, <br />X <br />ALL OWNED SCHEDULED <br />AUTOS _...NON -OWNED <br />HIRED AUTOS X -AUTOS <br />BODILY INJURY (Par accldenl) <br />I'n PCRTY7AMA[3F:.._.. .....___ <br />,(1'or,actlde2k) <br />S <br />.—.. .............. <br />_ <br />UVIDRELLALIAa OCCUR <br />EACHOCCURRENCE <br />$ <br />EXCESS LIAe . , , <br />AGGREGATE <br />$ <br />WORKERS COMPENSATION <br />AND EMPLDYenS' LIABILITY <br />ANYPROPRIrt WNRTNERrEXECUTIVEYI" <br />OFFICERlMEMBEXXCLLUDG6? <br />NIA <br />PER OTH <br />TATi1 — —F,J — <br />E,L.EACH ACCIDENT <br />S <br />E,L;DISEASE-EA EMPLOYEE <br />$ <br />(MnndatarytdRHI <br />II yae, describe under <br />DESCRIPTION OF 0 ERATIDN$ b9tow <br />E.L. DISEASE . POLICY LIMIT <br />I <br />A <br />BIMLeaselRented <br />T <br />45488712 <br />11/19/2016 <br />11119/201 <br />$200,000 Llmltlltem <br />Equipment <br />L <br />$2,500 Deductible <br />DESCRIPTION OF OPERATIONS r LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Sthaduls, may be attached If more specs Is required) <br />*Evidence of Coverage SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES 39 CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS, <br />AUTHORIZZO REPRESENTATIVE <br />191DUB-ZO14 ACORD CORPORATION. All rights reserved, <br />ACORD 25 (2014/01) 1 of 1 The ACORD name and logo are regletered marks of ACORO <br />#S392897IM392894 JXW <br />