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Public Parking Facility - 121 E. Wayne St., 109 W. Jefferson Blvd., 126 N. Main St. - LAZ
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Public Parking Facility - 121 E. Wayne St., 109 W. Jefferson Blvd., 126 N. Main St. - LAZ
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Last modified
4/17/2025 10:09:25 AM
Creation date
3/12/2024 2:49:47 PM
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Board of Public Works
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Recommendations
Document Date
3/12/2024
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AGENCY CUSTOMER ID: 25084 <br />ACrpRp�° LOC#: Sae ACORD 25 <br />%---- ADDITIONAL REMARKS SCHEDULE Pa e� of <br />AGENCY NAMED INSURED <br />Amity Insurance A Division of Brown & Brown of MA LLC <br />PCUCY N UMEF,R <br />See Certificate See ACORD 25 <br />CARRIER NAIC CODE <br />See Certillcate <br />EFFECTIVE PATE: 713112023 <br />ADOMONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS ASCHEOULE TO ACORD FORM, <br />FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURER G: American Guarantee & Llabllity Insurance Company <br />26247 <br />INSURER H: Westfield Specialty Insurance Company <br />16992 <br />INSURER I: Great American Assurance Company <br />26344 <br />INSURER J: <br />ADDITIONAL POLICIES IIf a policy below does not include limit Information, refer to the corresponding policy on the <br />INSR I ADDL I SUBR I EFFECTIVE EXPIRATION <br />LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER DATE DATE <br />(mm/ddtyW) (mm/d&/ W) <br />certificate <br />LIMITS <br />IzA ;I=55 GENERAL <br />D LIABILITY <br />XLXD6109900S <br />7/31/2023 <br />7/31/2024 <br />AGGREGATE <br />$4,000,000 <br />E UMBRELLA LIABILITY <br />79863543 <br />7/31/2023 <br />7/31/2024 <br />AGGREGATE <br />$25,000,000 <br />EXCESS LIABILITY <br />F <br />XC9EX00286231 <br />7/31/2023 <br />1 7/31/2024 <br />AGGREGATE <br />$15,000,000 <br />G EXCESS LIABILITY <br />AEC011173109 <br />7/31/2023 <br />7/31/2024 <br />AGGREGATE <br />$15,000,000 <br />EXCESS LIABILITY <br />" <br />XSL345214K00 <br />7/31/2023 <br />7/31/2024 <br />AGGREGATE <br />$10,000,000 <br />EXCESS LIABILITY <br />I <br />EXC5125913 <br />7/31/2023 <br />7/31/2024 <br />AGGREGATE <br />$10,000,000 <br />E EXCESS LIABILITY <br />78187246 <br />7/31/2023 <br />7/31/2024 <br />AGGREGATE <br />$25,000,000 <br />ACORD 101 (2008/01) ® 2008 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are reglstered marks of ACORD <br />
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