HomeMy WebLinkAboutINSURANCE - 06 -00137 - SimplexGrinnell LP - Fire Safety CertificationPRODUCER
Marsh, Inc.
1166 Avenue of the Americas
New York, NY 10036
Telephone (212) 345-5000
iNk'Dincij
ShPlexGrinnell, LP
1 272 W 2240 SOUTH
SALT LA Fz CITY, UT 84119
United States
GERTIFICATE OF INSURANCE CERTIFICATE NIJMLE9
253644
FTHISEFiTIFfCATE IS ISSiJED A$ AMA7iER OF II`�fF0RMA7lOf+f ONLY AfVD CpfVFERS NO RIGHl'S
THEE CEFiiiF1CATE H(}LDEFi OTHER TNAIV 7FtOSE pFipVIDED I1V TFIE POLICY. iNlS
FfCATE pQES NQ7 AMEf�lD, EXTEND OR ALTER THE CQVERQGE AFFQi�pEb 8Y 7i-lE
ES DESCRIBED HEREIN,
COMPANIES AFFORDING COVERAGE
COMPANY A. Al South insurance Co.
COMPANY B: American Home Assurance Co.
COMPANY : Illinois National' I n u ranee Co.
COMPANY L : InsurancernMnnn of
COMPANYE.-
COMPANIES
.
National Union Fire Insurance C.
COMPANY FANY F: New Hampshire pshir Ins. Co.
COMPANY Y New York Marine & General Insurance
COVERAGES
H. Noetic SpecialtyInsurance o an
THI'S IS TO ERTEFY THAT aTi-1E POLII ES OF INSURANCE DESCRIBEDHEREIN SUBJECT
HEFEIN
H.d
E BEEN ILECTO rN E INSURED NAMED HEREIN FOR THE POLICY PERIOD IDIATED. N T
�IT--ANS RE.IRIITfTTER OR CONDITION F ANY CONTRACTOR OTHER ]DOCUMENTWITH RE PELTT S
T
AN SI SG�FE EPTIFI ATE MAY BE ISSUED R MAY PERTAIN, THE INSURANCE
AFFOR
N URANCAFFCR EI THE POLICIES LI TED f JE T T ALL THE TERMS, aNMITI N AND LCL��V�F LW POLICIES, AGGREGATE LJIITS,H0VVN MAY HAVE BEEN REDUCED By
PAID CLAIMS.
CO Typrz OF INSURANCE
i.7R
B I GENERAL LIAR LIT
COMMERCIAL GENERAL LIAEJLITY
CLAIMS MADE FxOCCUR
�_.
OWNER'S & CONTRACTOR'S PROT
B AUTOMOBILE LIA13ILI7Y
B X I ANY AUTO
6
B ALLOWED AUTC35
� SCHEDULED AUTOS
I X HIRED AUTOS
i� K NON -OWNED AU705
�I
PROPERTY
EXCESS LIABILITY
UMBRELLA FORIM
OTHER THAN UMBRELLA FOR
13 WORKERS MPEN ATION AND
E EMPLOYERS' LIABILITY
THE PROPRIETOR/
PARTNERS/EXECUTIVE iN L
I OFFICERS ARE
EL
[OTHER
POLICY NUMBER
RMCA3017798
{TX}
RMGA3017799
(ACS)
RMCA3017797
(MA)
RMGA3017796
(VR)
FEE PAGE TWO
DESCRIPTION OF + Pr=RATI NSIL ATlC)I I E I LE / FE LL ITEMS
Please see rage 2 for additional insureds and any additi
orial language.
CERTIFICATE MOLDER
City of Rexburg
19 E Main St.
Rexburg, I D 83440
POLICY AFFECTIVE POLICY EXPIRllT10iV L3M17S
GATE (MMIDQlYYj DATE (NENEfaDfYY)
10/1/2005
10/1/2005
10/1 /2005
10/1/2005
10/1/2005
10/1/2006 � GENERAL AGGREGATE
AGG
PERSONAL & ADS' INJURY
EACH OCCURRENCE
I FIEDAMAGE I,.Anr arc fire)
FED EXP (Any one person)
10'1/2006I BINES D SfNGLrm I! i IT
10/1/2006
10/1/2006
BALI' I.
10/1/2006JURY (Per person)
BODILY INJURY (Per accident)
PROPERTY DAMAGE
EACH OCCURRENCE
AGGREGATE
SEE PAGE T C SEE PAGE TWO—f 1 x I WC STATUTORY
LIM TS
EL EACH ACCIDENT
T
CANCELLATION
LITH ER
EL DISEASE-PC)LI Y LIMIT
EL DISEASE -EACH EMPLOYEE
$15,000,000.00
$795001000.00
$7,5005000.00
1 100-01000.00
$71,500,000.00
$2,0001000.
+$2a0000000.00
$210003000.00
HOULI) ANY OF THE POLICIES OESEHIIE1) HF11E'•h! Ila— CANCCE �.
INSURER A� FORL)I G COVERAGE 1� K.L ENDEAVOR TO MAIL 30 DAYS 10JR 7rEN NOT ;RE THE E TO 1O� DATE TFcATE
OLDER
INAI,THE
VIED HEREIN, BUT FAILURE TO MAN SUCH NOTICE -SHAD IMPOSE NO 08UGATION0-91 IA91 Thr' OF '�rKiND PO
THE INSURER AFFORDING COVERAGE, ITS AGES aT R REPRESENTATIVES, OR THE ISSUER OF THIS CEIRT)P1rA7.:;
rv]Ahbl--f U6A INC, BY
Katherine 'Leery. Ca ua-J#yr Program
MM 1 (3102)
VALID AS OF: 3/712006
Pr9DU ER
Marsh, Inc,
1166 Averyu e of the Americas
New York, NY 10036
Telephone (212) 345-5000
INSURED
SimpiexGrinneil, LP
1272 W 2240 SOUTH
LT LAKE CITY, UT 84119
United States
TEXT
WORKERS COMPENSATION POLICIES
Carrier
(B) American Hone Assuroarice Co.
(F) National Union Fire Insurance Co.
D) insurance ompan p Of t'ne State o
(C) 111.1nois national Insurance Co.
( F) New Bapshire Ins. Co.
(A) AI South Insurance Co.
(B) American Home As3urance Co.
(B) American Home Assurance
LIAB —"IT PROGRAM
ADDITIONAL INFORMATION
Policy Number
R-MWC6610498
RM 610304
PA RMWC6610503
1001
RMWC 10505
1049
RMWC6610502
R !- 0500
Froj ct Fire .protection In tallcation f Maintenance,
COMPANIES AFFORDING COVERAGE
E
COMPANYa:' While fountain Insurance Cc).
Eff. . Date
10/1/2005
10/1/2005
10/1/2005
10/1/200
11005
10/1/2005
'}rte 0
10/1/200
Testing, In n tio,n,� Et, .
If there is a question regarding this rtificatelease ont(
1� met Jean Court
(Emaii : j court@ t C nt . Phns : 1- --940
CERTIFICATE HOLDER
City of Rexburg
19 E Main St.
Rexbu.rg, ID 83440
Exp- Date
10/1/2006
10.1/200
10/1/2006
10/1/2006
10/1/2006
10/1/2006
10/1.2006
10/1/2006
State
CA
OR
.f
MAI
IL.r
MI
NY,r
rit T 1
GA
FL
CERTIFICATE NUM13ER
253644
All Other � � t