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04:06 PM APPLEBEE'$ INTERNRTIONAL FAX NO, 9139678910 P, 02 <br /> <br />JUL-]5-98 UED <br /> <br />Ai Oltlt. <br /> <br />CERTIFICATE OF INSURANCE <br /> <br />I~UE OATE (MM/DO/fY) <br /> <br />PRODUCER <br /> <br />7~ <br /> <br />ISSUED AS A UATTI:n ne <br /> mA//:M UF INFORMATION ONLY AN~---- <br /> <br />Lockton C~panies <br />P.O. Box 419331 <br />Kansas City ~a 64141-6351 <br />(913) 676-9000 <br /> <br />COVERAGES <br /> <br /> CONFERS NO RIGHTs UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE <br /> DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED DY THE <br />~POLICIES BELOW. <br /> <br /> COMPANy <br /> <br />COMPANY ~ <br />GE.'rI'ER ~;~ <br /> <br />COMPANY <br />LETTER C <br /> <br />COMPANY n <br />COMPAN~ <br /> <br /> COMPANIES AFFORDING COVERAGE <br /> <br />NATIONAL UNION FIRE <br /> <br />TRAVELERS INDE~. CC~PANY ~F iLL. <br /> <br />INS. CO. OF PA. <br /> <br />AME'R[CAN HOME ~SIJRANEE <br /> <br />CO <br />LTR <br /> <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LI~'ED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RES/aECT TO WHICH THIS <br />C~RTIFICATE MAY BE ISSUED ORMAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HER~JN IS SUBJECT TO ALL THE TERMS. <br />EXCLUSIONS AND CON01TIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE GLEN REDUCED BY PAID CLAIMS. <br /> <br /> TYPE OF INGURANCI~ POLICY NUMBER POLICY EIeFECTIV~ POt. ICY EXPIRATION <br /> DATE (MMIDD/YyI DATE EMM/00/YY) LIMITS <br />GENERAL LIAalLITy <br /> <br /> L IQUnR LIAB. <br /> <br />.I, UTOMOIILE. LIAL~ILIT¥ <br /> ANY AUTO <br /> <br /> AIL. OWN[0 AUTOS <br /> ~CHEDUL~O AUTOS <br /> ~RE~ A~OS <br /> N0~0WNED AUTOS <br /> <br />COMMeRCiAL GcN£R.,. L,Ae..ITy RMGLIIJSI2B <br /> CLaiMS MAD~ X OCCUR <br />OWNEr'S & CONTRAC¥OR'5 P~OI' <br /> <br /> $1,000,000 COMM~ CA-~J <br /> <br />RMCA3207388 <br /> <br />EXCESS LIABILITY <br /> <br />10/01/97 10/01/98 <br /> <br />10/01/97 10/01/98 <br /> <br />X UMBRELLA FORM <br /> 0Tiler THAN UMBRELLA <br /> <br />7SF 3CUE271T5-~8-~-~7 <br /> <br />[0/01/~7 IO/O1/?D <br /> <br />COMBINED SINGLE <br />LIMI'I' $ <br /> 1,000,000 <br />~qDoILy INJURY <br />(Pe'~ ~,ermon) <br /> XXXXXXXXXXX <br />80OILY INJURY <br />(Per acc~EenfI S <br /> XXXXXXXXXXX <br />PROPERTY [~MAG; <br /> ...Xxx, X.X. xxxxx~. <br />[~CH OCCVqnENCE S3, O00,000 <br />AGGRE~^r~. sj, 000,000 <br /> <br /> WORKER'S COMPENSATION <br /> AND <br /> £MPLOYEI~' LIABILI?Y <br /> <br />OT~ER <br /> <br />RISC 116~.9-,~4 / .:-_,- J6... 10/01/97 <br /> <br />10/01/98 <br /> <br />D REAL & PERSONAL IMB 46500-92 <br /> PROPERTY <br /> <br />!0/01/97 <br /> <br />DESCRIPTION OF OPERATIONS/LOCATIONSIVENiCLE$/Spf.,CiAL ITEM~ <br /> <br /> "SPECIAL CAUSE OF LOSS <br />IO/O1/gB FORM" $2,000. CED. <br /> REPLACEMENT COST A~REE~ <br /> jMOUNT. <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br /> 265975 <br />***S P I=' C ! PI E <br /> <br />,.ACORD 25-S (7/90) <br /> <br />SHOULD ANY OF: THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TH~ <br />EXP~F(ATION DATE THEREOF. THI= iSSUiNG COMPANy WILL ENDEAvoR TO <br />MAIL ~ DA~ WRI~EN NO~CE TO THE CEMTI~AIE WOLDE~ NAMED TO ~E <br />LEFT, ~UT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR <br />LtABtU~ OF ANY KIND UPON THE COMPANY. ITS AGENTS OR R~PRESENTATtV~$. <br /> <br /> AUTNORIZE D ./~E PRE SE NTATIVE * <br /> <br />~/ -----..°.A~CORD CORPORATION <br /> <br /> <br />