Standard Certificate Of Insurance

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Insured: Name Address: Telephone Number: ( ) Fax Number: ( ) Location and nature of operation or contract to which this Certificate applies: Policy Dates Type of Insurance Company Policy Limits of Liability/Amounts Effective Expiry Section 1 – Primary Bodily Injury Property Damage Inclusive Aggregate Deductible Bodily Injury Property Damage Commercial General Liability (Occurrence Basis) Section 2 Automobile Liability Inclusive Inclusive Section 3 Excess/Umbrella Section 4 Additional Insureds as required by contract: 1..


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