Example: marketing

AmTrust International Underwriters Limited d …

AmTrust International Underwriters Limited administered by: United Contractors Insurance Services Group, Inc. 43725 Monterey Avenue, Suite A. Palm Desert, CA 92260. COMMON POLICY DECLARATIONS. Policy Number: DSI 1046425 00. INSURED'S NAME & ADDRESS: Hayk Grigoryan IFIXIT Plumbing 1239 Spazier Avenue Glendale, CA 91201. POLICY PERIOD: From: 7/8/2014 To: 7/8/2015. AT 12:01 Standard Time at your mailing address shown above. IN RETURN FOR THE PAYMENT OF PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE. TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. FORM OF NAMED INSURED'S BUSINESS: X. DIndividual DJoint Venture DLimited Liability Corporation DPartnership D Corporation DOrganization (other than Partnership or Joint Venture).

AmTrust International Underwriters Limited d Administered by: United Contractors Insurance Services Group, Inc. . 43725 Monterey Avenue, Suite A

Tags:

  International, Limited, Underwriters, Administered, Stratum, Amtrust international underwriters limited d, Amtrust international underwriters limited d administered

Information

Domain:

Source:

Link to this page:

Please notify us if you found a problem with this document:

Other abuse

Transcription of AmTrust International Underwriters Limited d …

1 AmTrust International Underwriters Limited administered by: United Contractors Insurance Services Group, Inc. 43725 Monterey Avenue, Suite A. Palm Desert, CA 92260. COMMON POLICY DECLARATIONS. Policy Number: DSI 1046425 00. INSURED'S NAME & ADDRESS: Hayk Grigoryan IFIXIT Plumbing 1239 Spazier Avenue Glendale, CA 91201. POLICY PERIOD: From: 7/8/2014 To: 7/8/2015. AT 12:01 Standard Time at your mailing address shown above. IN RETURN FOR THE PAYMENT OF PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE. TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. FORM OF NAMED INSURED'S BUSINESS: X. DIndividual DJoint Venture DLimited Liability Corporation DPartnership D Corporation DOrganization (other than Partnership or Joint Venture).

2 BUSINESS DESCRIPTION: PLUMBING. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PART FOR WHICH A MINIMUM AND. DEPOSIT PREMIUM IS INDICATED. 20% (PERCENT) OF THIS DEPOSIT IS FULLY EARNED AT THE. INCEPTION DATE OF THIS POLICY. INSPECTION FEE AND 20 PERCENT OF ALL OTHER FEES ARE FULLY. EARNED AT TIME OF BINDING. THIS POLICY IS SUBJECT TO AUDIT. COVERAGE ITEM AMOUNT. CGL Premium $1, Endorsement Premium $ Filing Fee $ Inspection Fee $ Program Fee $ Service Fee $ Taxable Amount $1, CA Stamping Fee $ CA Surplus Lines Tax $ PROCURED BY: Douglas R Holmes 43725 Monterey Avenue, Ste A By: Palm Desert, CA 92260 Surplus Line License #0E84101. THIS COMMON POLICY DECLARATION AND THE SUPPLEMENTAL DECLARATION TOGETHER WITH THE COVERAGE PART, COVERAGE FORMS AND ENDORSEMENTS ISSUED TO THE INSURED AND FORMING A PART THEREOF, COMPLETE THE ABOVE.

3 NUMBERED POLICY. UCISG-CGL-DEC1 Page 1 of 2 Ed. 0413. COMMERCIAL GENERAL LIABILITY COVERAGE PART. SUPPLEMENTAL DECLARATIONS. Policy Number: DSI 1046425 00. LIMITS OF INSURANCE: EACH OCCURRENCE LIMIT $ 1,000,000. GENERAL AGGREGATE LIMIT $ 2,000,000. PRODUCTS/COMPLETED OPERATIONS $ 2,000,000. PERSONAL AND ADVERTISING INJURY $ 1,000,000. HOT TAR/TORCH DOWN SUB-LIMIT $ 100,000. FIRE CAUSED BY HEATING DEVICE SUB-LIMIT $ 100,000. FIRE LEGAL LIABILITY $ 50,000. MEDICAL EXPENSE LIMIT ANY ONE PERSON $ 5,000. SELF INSURED RETENTION $ 1,000 PER CLAIM. DEFENSE EXPENSES, AS THAT TERM IS DEFINED IN THE POLICY, ARE INCLUDED. WITHIN THE LIMITS OF LIABILITY PROVIDED BY THIS POLICY. SCHEDULE OF PREMISES: ADDRESS: Same as Common Declarations PREMIUM.

4 CLASSIFICATION CODE PREMIUM BASIS RATE PREMIUM. PER $1,000 GROSS RECEIPTS. PLUMBING 98483 54,000 828. Adjustment to Minimum Premium 172. TOTAL MINIMUM & DEPOSIT PREMIUM: $ 1, Forms and Endorsements applying to this Coverage Part and made a part of the policy at time of issue: SEE SCHEDULE OF FORMS ENDORSEMENTS, UCISG-CGL-SCH (05/10/13). THESE DECLARATIONS ARE PART OF THE POLICY DECLARATION CONTAINING. THE NAME OF THE INSURED AND THE POLICY PERIOD. UCISG-CGL-DEC2 Page 2 of 2 Ed. 0413. SCHEDULE OF FORMS AND ENDORSEMENTS. Attached to Policy number: DSI 1046425 00 Date: 7/8/2014. FORMS ATTACHED TO AND MADE A PART OF THIS POLICY AT INCEPTION. FORMS NUMBERS FORM TITLES. UCISG-CGL-DEC1 Declarations Page UCISG-CGL-DEC2 Supplemental Declarations Page UCISG-CGL-SCH Schedule of Forms and Endorsements AIUL SIGNATURE PAGE USI Signature Page CPS33002 AIUL SOS Service of Suit CA D2 California D-2 Surplus Lines Notice IL 00 21 Nuclear Energy Liability Exclusion Endorsement CG 21 84 Exclusion of Certified Nuclear, Biological, Chemical or Radiological Acts of Terrorism CG 21 70 Cap on Losses from Certified Acts of Terrorism UCISG-BIP Bodily Injury on Property Owned by Insured UCISG-BAI Blanket Additional Insured Endorsement UCISG-CGL Commercial General Liability Coverage Form UCISG-CGL-SCH Page 1 of 1 Ed.

5 0413. AmTrust International Underwriters Limited IN WITNESS WEHEROF, THE COMPANY HAS CAUSED THIS POLICY TO BE SIGNED BY ITS. PRESIDENT AND SECRETARY AS DULY AUTHORIZED REPRESENTATIVES OF THE COMPANY. Ronan Conboy President Noel Morris - Secretary POLICYHOLDER NOTICE SERVICE OF PROCESS. Service of process for any suit instituted against AmTrust International Underwriters , Ltd. concerning this Policy may be made upon the Superintendent, Commissioner, or Director of Insurance or other person specified for that purpose in the statute or his/her successor or successors in office as their true and lawful attorney upon whom may be served any lawful process in any action, suit, or proceeding instituted by or on behalf of the Insured or any beneficiary hereunder and arising out of this Policy.

6 AmTrust International Underwriters , Ltd. has designated: Mr. Stephen Ungar, Secretary AmTrust International Underwriters , Ltd. 59 Maiden Lane, 6th Floor New York, NY 10038. as the person(s)/organization to whom the Superintendent, Commissioner, or Director of Insurance or other specified person is authorized to mail such process or a true copy thereof, in compliance with the applicable statutes governing said service of process in the state or jurisdiction in which a cause of action under this Policy arises. CPS33002 Page 1 of 1 Ed 1211. AmTrust International Underwriters , Ltd. COMMERCIAL GENERAL LIABILITY. CG 21 70 01 08. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM.

7 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. LIQUOR LIABILITY COVERAGE PART. OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART. POLLUTION LIABILITY COVERAGE PART. PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART. RAILROAD PROTECTIVE LIABILITY COVERAGE PART. UNDERGROUND STORAGE TANK POLICY. If aggregate insured losses attributable to terrorist "Certified act of terrorism" means an act that is acts certified under the federal Terrorism Risk certified by the Secretary of the Treasury, in Insurance Act exceed $100 billion in a Program Year concurrence with the Secretary of State and the (January 1 through December 31) and we have met Attorney General of the United States, to be an act of our insurer deductible under the Terrorism Risk terrorism pursuant to the federal Terrorism Risk Insurance Act, we shall not be liable for the payment Insurance Act.

8 The criteria contained in the Terrorism of any portion of the amount of such losses that Risk Insurance Act for a "certified act of terrorism". exceeds $100 billion, and in such case insured losses include the following: up to that amount are subject to pro rata allocation in 1. The act resulted in insured losses in excess of $5. accordance with procedures established by the million in the aggregate, attributable to all types of Secretary of the Treasury. insurance subject to the Terrorism Risk Insurance Act; and 2. The act is a violent act or an act that is dangerous to human life, property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion.

9 CG 21 70 01 08 ISO Properties, Inc., 2007 Page 1 of 1 . POLICY NUMBER: DSI 1046425 00. THIS ENDORSEMENT CHANGES THE READ IT CAREFULLY. Bodily Injury On Property Owned By Insured Exclusion 11 entitled Bodily Injury On Property Owned By Insured contained in Section I, Part B Exclusions is deleted in its entirety and replaced with the following: 11. BODILY INJURY ON PROPERTY OWNED BY INSURED (revised). Coverage provided by this policy is extended to bodily injury arising out of or connected to: (a) Real property owned, rented or occupied by the Named Insured but only if the real property is a place of operations for the Named Insured; or (b) Real property owned by the Named Insured on which the Named Insured is engaged in a currently active construction project.

10 (c) Coverage in this policy is in excess of any liability insurance that provides coverage for the above-described real property. Coverage is not extended to bodily injury arising out of or connected to property owned or rented by any Insured which is vacant, undeveloped, or unoccupied or a construction project which is dormant for any reason for any period of time. UCISG BIP-1 Page 1 of 1 Ed. 0713. POLICY NUMBER: DSI 1046425 00. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED ONGOING OPERATIONS. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. 1. Section II Who Is An Insured, paragraph 3 is amended to include, for Coverage A liability only, as an additional insured, the person, entity or organization designated in this endorsement for whom the Named Insured is performing ongoing operations only when the Named Insured has agreed with the person, entity or organization in an insured contract to name the person, entity or organization as an additional insured.


Related search queries