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From; <br />11/2~12011 ~9:3~ 903~~516~9 <br />~ 17, C3arage Liability <br />9 8. Garage keepers' l,egal <br />19.pwners Protective <br />11/28l2011 12;02 #789 P,003I003 <br />MDRP~LL AUTQ GRQUP PAuE 06/09 <br />$_8i & PD each orcurrence <br />Comprehensfve <br />$ - Colllslan <br />Itmits $500,pQ0 Combined slngle <br />Glablllty <br />J .~„C- 20_ Clty named as additianal Jnsured on othee: than:.Workers;, Carnpansaflon_ This <br />coverage is primary ta aN other coverages tha C(ty may posse9s, <br />~C 21. Cfty prov}ded wjtt~lN~iaer~o€~W~rog,~ftq~t,-or~~l~/t~►'kof8';GOmpe ttis~tfon.~ar:A';' Alternatlve <br />prAgrarrt If appifaable. <br />~ 22 Ten (10) days notice of cancellatian, non-renewal, materiel change or ctiVerage <br />raductfon endoraernen# rsquirad. The words "endeavor to" and "but failure" (ta end <br />of sentence) ara tv be ellminateq from the Notlce of Canceilatlnn provtsion on <br />standard ACC7RD certificates. <br />/ ..,,,X,,. 21 Tha City af farls <br />$ a`"nat applfcable for workers' compensaffon assigned through pQp! Or <br />aIternatlue campensat#an pragrams), n- (EX 0 .i,t.1{ iJ-) rl'ii Sj XV <br />24, The GertlffCate must state bfd numbar and bld titfe or prdject name. <br />- 25. Qther Insurance Required: <br />IN,5WFZANQE AG 'S SIATEhdgtqT <br />I have reviewed these roqufrements with fhe bldder named below. Additionally; <br />X 26. The above policy(s) Carry the following daduqUbloS: <br />Fu!l lirnfts af coverage avaffahle far. <br />Ganerai Liabiiity <br />Autvmabtla LiabJlity. <br />X 27, L{&bility pplicies are (indicate): <br />OCGURRCNCrz C11~ CLAfMS MADE ( j <br />~ <br />' ~6 1,e.y. r' <br />lnsurance Agent (Print) ` <br />r,. <br />Si afur <br />Date <br />