|
���IrI��' �� � �Mu � � j ' ��� a , �: ISSUE DATE(MM/DD/YY)
<br /> '�' a ;�.A;.:
<br /> , � . `. , . .. .�, Y �. . , . , :�. ,,, . a6-as-a�
<br /> PRODUCyER�. �.'„ � THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
<br /> ED�JARR ��COBS & COMPANY NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,
<br /> SPECSA� Fl�SICS DIVISION EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
<br /> 4'17 NINTH AVE. #107
<br /> SAN MATEO, CA 94402 COMPANIES AFFORDING COVERAGE
<br /> COMPANY A INSURANCE CO OF NORTH AMERICA
<br /> LETTER
<br /> CODE SUB-CODE
<br /> COMPANY B ROYAL INDEMNITY COMPANY
<br /> INSURED LETTER
<br /> UNITED ARTISTS ENTERTAINMENT CO. COMPANY pACIFIC EMPLOYERS INSURANCE CO
<br /> 2 9 3 0 E. 3 RD AVE. LETfER C
<br /> DENVER, CO 80206 COMPANY
<br /> LETTER � '
<br /> REC'D RPSK MGT.
<br /> COMPANY E
<br /> LETTER
<br /> r��/���� ' :,,.`,. ', . ,
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOV�FOR THE POLICY PERIOD
<br /> INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WIT �A��.T�MOIl�H 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 /> CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION pLL LIMITS IN TNOUSANDS
<br /> LTR DATE(MM/DDlYY) DATE(MM/DD/YY)
<br /> GENERAL LIABILITY GENERAL AGGREGATE $
<br /> A X COMMERCIALGENERALLIABILITY XSL GO 569890—A 07-01-89 O7—OZ-9O PRODUCTS•COMP/OPSAGGREGATE $ lOOO
<br /> CLAIMS MAD� }� OCCUR. PERSONAL&ADVERTISING INJURY $ 'Jr OO
<br /> X OWNER'S&CONTRACTOR'S PROT, EACH OCCURRENCE $ 'Jr OO
<br /> FIRE DAMAGE(Any one fire) $ 5O
<br /> MEDICAL EXPENSE(Any one person) $
<br /> AUTOMOBILE LIABILITY COMBINED
<br /> A X ANYAUTO ISA OOZO�2 07-01-89 07-01-90 LIMTLE $ lOOO
<br /> ALL OWNED AUTOS BODILY
<br /> INJURY $
<br /> SCHEDULED AUTOS (Per person)
<br /> HIRED AUTOS BODILY
<br /> INJURY $
<br /> NON-OWNED AUTOS (Per accident)
<br /> GARAGE LIABILITY
<br /> PROPERTY $
<br /> DAMAGE
<br /> EXCESS LIABILITY EACH AGGREGATE
<br /> OCCURRENCE
<br /> B X RHN 000758 07-01-89 07-01-90 $ 5000 $ 5000
<br /> OTHER THAN UMBRELLA FORM
<br /> WORKER'S COMPENSATION STATUTORY
<br /> C ANp �.'�.'�J C3 344685�8 07^01�89 07��1�90 $ 10(�� (EACHACCIDEN�
<br /> . $ ZOOO (fl�SEASE—POLICY LIMIT)
<br /> EMPLOYERS'LIABILITY
<br /> . $ ZOOO �DISEASE—EACH EMPIOYEE
<br /> OTHEH ,
<br /> D .
<br /> D .
<br /> D MEDIA/PROF LSP7, 301,547A/XEX.1307610 �.�.-25-88 $5,000/6,000
<br /> DE3CRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS 41211 UA CABLESYSTEMS OF ILLINOIS
<br /> CERTIFICATE HOLDER IS HEREBY NAMED AS ADDITIONAL INSURED IF REQUIRED
<br /> BY WRITTEN CONTRACT, LEASE AGREEMENT OR MORTGAGE AGREEMENT.
<br /> ��I�ii�tf i��1✓{iY iZ��' s :.i�,'�, . . , � . . � , d r a e i�' � . .. �.,t,`�e.,,\ , , .. , . .
<br /> � .�^;.L."?^d-'��kre
<br /> ,... . .. .. . :.,$,'� , , ���. '�t" . . ,
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br /> CITY OF DECATUR � EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
<br /> 1 CIVIC CENTER PLAZA nnai�30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
<br /> CATUR, IL 62523 �.� �EFr, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
<br /> LIABILITY OF ANY KIND UPON THE CO NY, ITS G NT REP ES TIVES.
<br /> AUTHOflIZED REPRESENTATIVE �
<br /> �RON MO�2ELAND — VICE PRES D T
<br /> . . � . . ;q�� .a:°°c�„ia: .:
<br /> l�`�i� `� `?:w, •;, aq::.y,..
<br /> ',vi" f�;y`� ;ti�i
<br />
|