HomeMy WebLinkAboutINSURANCE POLICY DECLARATIONS - 08-00059 - Nelson Fire Systems - Fire Saftety CertificationUUMMUTA rULIU1 u�t,vu+nl Ivrvo
RENEWAL OF A, DCOTTSDALE INSURANCE COME, --NYS
cl slzslss6_ Home Office:
One Nationwide Plaza • Columbus, Ohio 43215
Administrative Office:
8877 North Gainey Center Drive • Scottsdale, Arizona 85258
1-800-423-7675
A STOCK COMPANY
ITEM 1. Named Insured and Mailing Address
NELSON FIRE SYSTEMS
1471 SOUTH MAJOR STREET
SALT LAKE CITY, CTT 84115
Agent Name and Address
BURNS & WILCOX, LTD.
2655 EAST COTTONWOOD PARKWAY SUITE 500
SALT LAKE CITY, UT 84121
Policy Number
CLS1385800
NO FLAT CANCELLATIONS
NOTICE: THIS POLICY CONTAINS
A MINIMUM EARNED PREMIUM
PROVISION. READ YOUR POLICY
Agent No.: 43003 _ Program No.: NONE
ITEM 2. Policy Period From: 06/01/2007 To: 06/01/2008 Term: 366 DAYS
12:01 A.M., Standard Time at your malling address.
Business Description: ALARM INSTALLATION
In return for the payment of the premium, and subject to all the terms of this policy, we agree with you to provide the
insurance as stated in this policy. This policy consists of the following coverage parts for which a premium is indicated.
Where no premium is shown, there is no coverage. This premium may be subject to adjustment.
Coverage Part(s)
Commercial General Liability Coverage Part
lommercial Property Coverage Part
commercial Crime Coverage Part
Commercial Inland Marine Coverage Part
Commercial Auto (Business Auto or Truckers) Coverage Part
Commercial Garage Coverage Part
Professional Liability Coverage Part
Premium
18,417
$ NOT
COVERED
$ NOT
COVERED
$ NOT
COVERED
$_ NOT
COVERED
$ NOT
COVERED
$ NOT
COVERED
Total Policy Premium: $ 18, 417.00
*POLICY FEE $ 625.00
*INSPECTION FEE $ 70.00
*FILING FEE
STAMPING FEE $
i3UREk ISSUING THIS POLITY DOES NOT HOLD A. TERTIFTO RE OF. AUTHORITY TO
DO BUSINESS IN THIS STATE AND THUS IS NOTFULLYR CEIVEES TO REGULATION ION EV $
THE OF
HEGUARANT ASSOCIATION THISPOLICYRECEIVHAPTER'ROTEGTIONFR^PA SURPLUS LINES TAX
ANY OF THE GUARANTY ASSOCIATIONS GREETED UHDER CRAFTER 2E. TITLE Stn"
TOTAL $ 19,997.04
made a part of this policy at time of issue:
SEE SCHEDULE OF FORMS AND ENDORSEMENTS
UTAH SURPLUS LINES TAXES & FEES FILED BY:
'NS & WILCOX, LTD.
ILLY EARNED RK/DH
THIS COMMON POLICY DECLARATION AND THE SUPPLEMENTAL DECLARATION(S), TOGETHER WITH
THE COMMON POLICY CONDITIONS, COVERAGE PART(S), COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS, IF ANY,
COMPLETE THE ABOVE NUMBERED POLICY.
OPS -D-1 (12-00) INSURED opsdlh.fap