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To Whorn it May Concern',L
January 15, zoos
Please be advised that Tyco
Ih.�� �°r� �r��i i, I �, Purchases insurance itsOperafions and subsidiaries i
idw" . Thos 'coverage
Genera I/Prod acts Liability, rcoverage
PFOPerty Insurance, Trans!VCargo
many others.nsurance, Workers COmpensation/Employers Liability,
and t as wefl a
TYC;07s iiio:rate policy to not Issue insurance rfi fiCat r other detailed , coverage
statements, Ontli actual wntmcts e been agreed to, Once Contracts are drawn up, we are
more than willing to ducertifii v"expedient Manner iri a format shown by o den in our ire
letterur sample
thisyco insuCance form_ Until such time, Cease It
International does purchase insurance
i� ������ r��i�., � �that complieswith
stow , and practices for all S to territories,
Canada, Mexico, along with t countries In the world_ FIlease
company Whh annual reverues of over Billion and operates in over 80 countfies, The limits
and types of lnUrance we purchase are n accordance with companies f cornparable
9y
If you ha-ve any conuerns lonour incurance coverages, PleRSe put them in writing and forward
they can be properly addressed and res
pon dad to.
Sincarely,
Tyco Risk Management
Tyco International (US), Inc,
015/27/2005 11:07 8012623811 SIMPLEX13RIHNELL PACE 06/07
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UPON THE Ei�a�l�'I� k-IL.['��� �� THIS CER71FI
FORMAT] ONLYAND ���R �l� 1�I�IT
Marsh, i Inc. �+�N THOSE PRC'�D IN 7HE POLICY. THIS
CE D 0 ES N CST AMEND, I-= XTEND 'OR ALTER THE COVERACE AF
60 ef'iu of the �1meriii POLICIES DESCRIBED HEREIN -
New FORDED �� �I�
York, NY 1
Telephone 212 345-500o COMPANIES AFFORDING COVERAGE� -.•.f:�l�a
COMPANYAl Scuth ire ur Cc,
INSURED
MP . American 110me Aswrance Co.
plexIGNn eh, LP
1272 W 2240 SOUTH r COMPANY : Illinois
National Insurance
SALT LAKE UTY, UT 8411
United States -
COMPANY D: Insurance CCMp8hy of the State
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fa[-+sSkI gg tliFx{ IvF s., rc, xT#I+CERTIFY THAT
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ANY ERTHE POY P�10�I LIf EQTS. TERM oFjDITI M OF ANY CONTRACT R OTHER INDICATED. NOTWIT T DI1LI �I INSURANCE E EIN H BEEN ISSUE�C THE INSURED NAMED EI tCf`
L�-I H ��� CERTIFICATE TE M13F ISSUED OR MAY PERTAIN, THE INSURANCE
AFFORDED 13Y THE POLICIES LISTED HEREIN 18 SUE3JECT TO ALLTHE TEF FC01❑I rf-EXCLUSIONS
1[SAID lAIMS. :.
wcL
1 4'a:C
OF SUCH POLICIES. AGGREGATE LIMITS I! liVN MAY HAVE BEEN REDUCED B
LTR
I TYPE OF INSURANCE
B GENERAL LIA RI LITYT
X C0 WE RC IAL G ENE RAL LI ABILITY
N CLAIMS MADE K OCCUR
OWNER"S & CON TRACTOR'S PROT
Ej AuraMaarLs L.[aeruTv
B }( ANY AUTO
� ALL0WEpAU7as
B
SCtiEpULEO AUTOS
X HIRED AUTOS
X NON -OWNED AUTOS
PROPEL
EXCESS LIABILITY
UNIRPELLA FORM.
OTHER THAN UMBRELLA FORM
IB WORKE RS CC MPEN AT] ON AN D
E EMPLO ERV LIAWLfTY
13 THE PROPRIETOR/
PARTNERSIEXECLITIVE INIAL
i
t
0THE R
Pauly Nume
RMGL5473558
RMCA1656703 (TX)
RMCAi 656702 (AOS)
RMCA1656704 (MA)
RMCA165E705 (VA,)
SEE PAGE TVVO
DESCRIPTION OF OP ERITIOM IL C T1 VJ EHICLESISPE IL ITEM
Mease see page 2 for addiflonal insureds and any additional language.
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POLICY EFFECTIVE
DATE (MWODINY)
10/1/2004
1 W1 12004
10/112004
10/112004
10/112004
EE PAGL TWO
PgL1CYEKp1AAiIDN� LIMITS
DATE (WM1DOfYY)
101112005
SEE SAGE TWO
GENERAL AGGREi8ATE
__E:$15ID001000.00
P ROD UCTS C APfOP AGG S151000,000.00
RE RSONAL
..6, ADV INlrrU l l $71500P900.00
Any Ino fired .
IED rP (Any one person) $101000.0{{'_
OMBINEID SINGLE LIMIT $77500000.00
F
BODILY INJURY (Per porson)
80DILY I N J U RY (Pgr acddent)
PROKRTy DAMAGE
EACH OCCURRENCE
AGGREGATE
I
�1-ATJ'fCRY
LIMITS
EL EACH AG I DF�I IT
EL DIFA,E-POLICY LIMIT
EL IDI EA E -E ISEMPLOYE:.
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4 12
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;514i�"r+liaik+kt3�k x��51i�Sr�.iCL{
9_#� V°®m L1r1k 4d' :F days+#�''�}i
$29000,000.00
2;0001000.00
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Il` T P��..I I8S t� CRIREO I`lEREr 9E 'CANcr=LLEQ 88FORE THE eXPIR LTION DATE THEREOF. TH �
�! tlR AFFORDING I 1 I. 0 T6 A'L— -3b DAY*SIT-rF-" NOfilQF_ 1-0 T`T �ERTIFI LTE HULER
NAM F-0 HEREIN, ElIJrT FAILURE TO MAIL SUCH N OTICS SHALL IMPOSE 40 Oft IGATION OR UA8?LI OF AW KNO UP rq
THE INSURER AFFORDING COVERAGF,ET'S AGENTS OR REPRESENTATIVES, OR THE I s tjER OF THIS GER -1 IMI TE _
MARSH LSSA, INC, Ur.
lchaaI Maaslei n, Ieoval ty Preigrarn
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