Laserfiche WebLink
QS DATE(MM!DDIY YYV) <br /> AC CERTIFICATE OF LIABILITY INSURANCE <br /> Lk.. 10J1312020 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. <br /> if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> CONTACT <br /> PRODUCER NAME;_--- <br /> Hiscox Inc. PHONE 3007 FAX <br /> ipoc.No.Exth (888)202- I(A/C,Now _ <br /> 520 Madison Avenue AIL <br /> ADDRESS: contact@hiscox.com <br /> 32nd Floor — -- <br /> New York,NY 10022 INSURER(S)AFFORDING COVERAGE NAICA <br /> INSURER A: Hiscox Insurance Company Inc 10200 <br /> INSURED INSURER B: <br /> Coqui Taxes — <br /> 2112 Madison st MSURERC: <br /> suite#6 INSURER D: <br /> Everett WA 98203 INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH 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 /> INSR ----- _ <br /> ADDLSUBR ----- I POLICY EFF f POLICY EXP I LIMITSLTR. TYPE OF INSURANCE INSD WVD POLICY NUMBER MI(MDD/YYYY) M/(MDD/YYYY) <br /> X I COMMERCIAL GENERAL LIABILITY ' EACH OCCURRENCE $ 1,000,000 <br /> CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 100,000 <br /> MED EXP(Any one person) $ 5,000 <br /> A I UDC-4628554-CGL-20 10/12/2020 10/12/2021 PERSONAL A AOV INJURY $ 1,000,000 <br /> GEM_AGGREGATE LIMIT APPLIES PER l GENERAL AGGREGATE $ 2,000,000 <br /> I i <br /> X POLICY JECTT i LOC 1 I I PRODUCTS-COMP/OP AGG $ SIT Gen.Agg. <br /> OTHER: ( $ <br /> AUTOMOBILE LIABILITY I I COMBINED SINGLE LIMIT <br /> _(Ea accident) $ <br /> ANY AUTO ! BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED <br /> AUTOS ONLY _- AUTOS <br /> BODILY INJURY(Per accident) $ <br /> '. <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY i (Per accident) <br /> $ <br /> UMBRELLA LIAB OCCUR i EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE I 1 I I I AGGREGATE $ <br /> 'DED RETENTION$ I $ <br /> WORKERS COMPENSATION '., I <br /> 1 AND EMPLOYERS LIABILITY Y/N I STATUTE i.ER <br /> ANYPROPRIETOR,PARTNER/EXECUrIVE OFFICEPo'MEMBER EXCLUDED? A ' i E.L EACH ACCIDENT $ <br /> ACCIDENT <br /> (Mandatory In NH) EL DISEASE-EA EMPLOYEE $ <br /> It yes,describe under — <br /> DESCRIPTION OF OPERATIONS below I ;EL DISEASE-POLICY LIMIT $ <br /> II <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCF7 I FD BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE — <br /> O 1988-2015 ACORD CORPORATION. Ad rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />