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<br />~ COMNiERC1AL
<br />C ERT9~'lCA~E OF I~S~9RAMCE ' '' r Issue' Date `{MMIDDIYY)
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<br />- ~_;,~ `. J~L This certificale is issued as a matter of information only and confers no rights
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<br />Address
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<br />coverage afforded by the policies shown below.
<br /> COMPANIES PROVIOING COdERAGE:
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<br />ST: 73 DISL ~ 5 AGENT ~~'~'
<br /> COMPANV
<br />~EnER p TRUCK INSURANCE EXCHANGE
<br />~ INSURED ~
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<br />C~i~:~:'A:~~;: ~;0_~"~'~ ;;I;,;; ~;`r; TE:~iS COMPANY
<br />~EnER g FARMERS INSURANCE EXCHANGE
<br />Name . _ . ~ ',". ; ~,.-^ ~
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<br />' '~T COMPANY
<br />LETTER r, MID~CENTURY INSURANCE COMPANY
<br />Address
<br />' COMPANY
<br /> LETTER D
<br />COVERAGES
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
<br />ANY RE~UIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN
<br />THE INSURANCE
<br />AFFOR~ED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AlL THE T ,
<br />ERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED
<br />BY PAID CLAIMS.
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<br />LTR. TYPc OF INSURANCE POLICY NUMBER POLICY EFFECTIVE
<br />DATE (MM/DO/YY) POLICY EXPIRATION
<br />DATE ~MM/DD/YY) POLICY LIMITS
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<br />t GEMERAL LIABIUTI' ~ i
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<br />1-~1-9
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<br />'i,i~ GENERALT
<br />AGGREGA
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<br />$ I
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<br /> COMMERCIAL 6ENEAAL LIABILITY ~ ~ ~~ PRODUCTS~COMPIOPS
<br /> - OCCURRENCE VERSION ,_„ ; (; _:;: ,;,; ;;; AGGREGA.TE $ i ~ ('~(!(` ~ ~,~( ~~'
<br /> CONTRACTUAL INCIDENTAL ONLY PERSONAL &
<br /> OWNERS & CONTRACTORS PAOT. ADVERTISING INJURY $
<br /> EACH OCCURRENCE $
<br /> fIRE DAMAGE (Any one fire) $ 7i, CGG
<br /> MEDICAL EXPENSE
<br /> (Any one person) $ 5 ~ C~0
<br /> AUTOMOBILE IIABILITI' COMBINED
<br />SINGLE LIMIT
<br />$
<br /> ALL OWNED COMMERCIAL AUTOS BODILY INJURY
<br /> SCHEDULED AUTOS (PER PERSON) $
<br /> HIRED AUTOS BODILY INJURY
<br /> NON OWNED AUTOS ~PER ACCIDENT) $
<br /> GARA6E LIABILITY PROPERTY DAMA6E $
<br /> GARAGE A6GREGATE $
<br /> UMBNELLA LIABILIT~ LIMIT $
<br /> WORKEBS' COMPENSATION STATUTORY
<br /> EACH ACCIDENT $
<br /> AND DISEASE-EACH EMPLOYEE $
<br /> EMPLO~ENS' LIA8ILITY DISEASE-POLICV LIMIT $
<br />DESCNIPTION OF OPERATIONSIVEHICLESIRESTNICTIONSISPECIAL ITEMS:
<br />CERTIFICATE NOLDER CANCECL{!T!0!:
<br />Name • ~ ~! \~ '~'1 ' -~'
<br />` SHOULD ANY OF TNE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEAEOf,
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<br />' TNE ISSUING COMPANV WILL ENDEAVOR TO MAIL YS WRITTEN NOTICE TO THE CERTIFICATE HOLDER
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<br />g _, ._ NAMED TO THE LEfT, BUT FAILURE TO MAII SU NOTI SHALL IMPOSE NO OBLIGATION OA LIABILITY OF
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<br />•~' ~~ ANY N THE COMPANY, ITS AGENTS REPRES TATIVES.
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<br /> AUTHORIIED REPRfSfN1ATIVE
<br />56-2492 4-94 1251
<br />G95 1401
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