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From; <br />11/28/2011 09:36 9037851628 <br />11i26l2011 12;02 #789 P.003J003 <br />Mo~~EI-~ AuTQ GRauP PauE 08r09 <br />- 17, Garage Liability $-gl & Pp each occurrence <br />- 18. Garage keepers' l,egal $ - Comprehensfve <br />$ - Caflision <br />W... 19.Owners Protective ~ $500,000 Combined single <br />Iimits <br />~iability <br />~ X 20. C(ty named as additional insured on akher than >Workers Cvrnpen5atlon. Th!s <br />aaverage is primary ta aII ather cavurages tha Cf#y may passess, <br />C 21.Cltyprov}dedwith',I+'tY6iveroB:Su.brogaflon:tan-Workers',;Gornpensatioraor, Alternaklve <br />pragram if applfcable. <br />~ 22_ Ten (10) days notice of canceliation, non-ranewal, rnaterial change or coVerage <br />reductian endor&emer1# requ+red. The words "endeavor to" and "buf fallUre" (tp end <br />Df SentenCe) ara ts3 be eqCPIiC1at8d frt7m ihd NC}tICe C1f C8t1Cellatlbn provtsfon on <br />standard ACORD certificatez, <br />21 The City of paris ~prefets sn A M;,,:,Best!s ",W1~'pr-+t~etter~~ar <br />. <br />$ aa ' no applleable for Workers' compensafiQn assigned through p4pl dr <br />aItOrnatlue aamponsatian pragrams), CI (Lx ev6-) ;-iii, <br />-X_ 24. Thq GertifiCate must state bid numbgr and bld title or prnject name. <br />- 25. Other fnsurance Required; <br />1NStJF'iANG,F; AGFN1"'S STATEUCVT <br />I have revlewed these requirements with fhe bldder named below. Addilionally: <br />X_ 26. The above palicy(e) Carty the follawing daduqtibles; <br />Fu!l limlfs af coverage available far: <br />Ganeral Liabillty <br />Automobfla Liabliity <br />X 27, L{ability policies are (indica#e): <br />OCGURRLNCE [1~ CLAIMS MADE IJ <br />F l <br />1 , V ~C7Ld J ~ V~,i r <br />1nsuranCe Agent (Prirtt) <br />y <br />Si atur <br /> <br />Date <br />167 <br />