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Insurance Binder

PHONE(A/C, No, Ext):GARAGE LIABILITYCAUSES OF LOSSTHIS Binder IS A TEMPORARY Insurance CONTRACT, SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE SIDE OF THIS (MM/DD/YYYY)AGENCYCOMPANYBINDER #EFFECTIVEEXPIRATIONDATETIMEDATETIMECODE :SUB CODE:DESCRIPTION OF OPERATIONS/VEHICLES/PROPERTY (Including Location)INSUREDTYPE OF INSURANCECOVERAGE/FORMSDEDUCTIBLECOINS %AMOUNTPROPERTYGENERAL LIABILITYVEHICLE LIABILITYVEHICLE PHYSICAL DAMAGEEXCESS LIABILITYAUTHORIZED REPRESENTATIVEAM12:01 AMPMNOONTHIS Binder IS ISSUED TO EXTEND COVERAGE IN THE ABOVE NAMEDCOMPANY PER EXPIRING POLICY #:BASICBROADSPECEACH OCCURRENCE$COMMERCIAL GENERAL LIABILITY$CLAIMS MADEOCCURMED EXP (Any one person)$PERSONAL & ADV INJURY$GENERAL AGGREGATE$PRODUCTS - COMP/OP AGG$RETRO date FOR CLAIMS MADE:COMBINED SINGLE LIMIT$ANY AUTOBODILY INJURY (Per person)$ALL OWNED AUTOSBODILY INJURY (Per acci)

this binder is a temporary insurance contract, subject to the conditions shown on the reverse side of this form. date (mm/dd/yyyy) agency company binder # effective expiration date time date time code: sub code: description of operations/vehicles/property (including location) insured

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