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<br />SEP-21-94 WED 15:44
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<br />P.D5
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<br />, BF, CERTIFICATE OF INSURANCE
<br /> .-ROD-Llef. TtCa.cnTICtt.,I" IS ItSUED.u A "ATTCll OF "'FOMIAT'ON C"~T ."'1> CO""'If."O .(:IlUQl'IT,
<br /> SeDGWICK' JAMeS 01 GEORGIA INC, UII'ON TME c:.lt'l'I'It:Uf lIIt)lM_, TNI'S eERTlrcJ. 'I'[ oou ~OT ...MCHO, tn,"",!> OR JiI~ UiI\ '"r.
<br /> COVEltlCE AF~r:M"'D fiT 'II' "(\Ilelf! tELOW,
<br /> 3333 Peochlree Rd.. N,E, .son COMPANIES. AFFORDING, COVEFlAG~
<br /> At/.,,,., Q.. 20326 ,,- eOYPAlI.lV
<br /> LiTTER A National UnIon FirA of Pjtt~bLHgh. Pa.
<br /> INl\lJRFr') ..
<br /> ('.()MP.ANV II Amencan Home AssuranCA ComPAny
<br /> U;m;. '-
<br /> COMPANY C
<br /> I FTTEA
<br /> .., ..,
<br /> COMPANY D
<br /> I FTTFR
<br /> .., ,,,-
<br /> COMPANY Ii:
<br /> LEn..
<br />-' ..,
<br /> '.It 10 tlf\lly l""llJO/lcl.. of ~.11et 1lIl'" btlow 1l.'IlII bf.n iAwd 10 lhl lnsurwd 1Ul1U1I.~ W INo 11'0 1_.. ~ P\ic.~, ~DI"I'IlhriIotl".n. lint ~..v.mom. 'ltr~, v' ""...,;,\..>01 ~ "I) wnrr.eot 0I1lI11tl'
<br /> """"'''"'''Ill l'lII'I I'ltPtCl KI "'-ICrlll'lll ctltKIa... m~ tit lKU.1S or lhIy 0tf\&lrI. Ihl 1n1l/ftllCl) II1foMror[ If, _ Ivll;,.;",., ..-..:~il:w<l "-"_ Hr ~1I1)/a.Ot tt .~ 11'to 10_. ~I,,,........ ."'11 GOlldldO'OI 01 ...~~, 1A4",."..
<br />CO, TYpe.: nF INCUAANCE POLICY NUMbE" POLICY OATI= Limit. of Liability In Thousande (000'1)
<br />LTR. , cJ'F. E~P.
<br /> -
<br /> GENEIW. UAalLn'Y I.iI:NhK.IIJ.. AU~6ATE S
<br /> X COMMERCIAL GEN9W, UABIUTY RMGL 3111-70S5 TX P1=lODVCTGCOMr"JOr' AOO. . 2,500
<br />A CLAlI\ll'S~ X CM....... 5/1104 511/95 fl:'PlSONA.L lAOIJ.IN.I~li=l"" . 2,500
<br /> X 0WNFq~ .. eoNnll\CTQF.I'1O PAOT. t.Ar.;I1 uu.:URRENCE . 2,500.
<br /> RMGI 319-7086 ALL OTHER nnt: D-\""ACC tMJ 0)(10; rll'" . 50
<br /> Mnl. ~N~ tAn;........ ~") . 5
<br /> AUTOtllOBIU! L!ARll ITY COW!.INR'l ",",Nr.:J 1= . ~,UOO
<br /> X ANY "UTO U"IT
<br />N X ALL OWNEC,...UfUV STATE AP,..KUVl:ll DOOlLYU"-'v51"f .
<br />I X SCWEC\UI.6D AIJTOf. ""'...-
<br />X IolIRiD AIJTOS !:FI F INSURER :;11194 511/95
<br /> BOOIl Y iNJURY .
<br />A X f\lON.ow~eGl AUIU~ ...."""onIl
<br /> GARAGJ::: UA"lllTY. S
<br /> f'Ko,)"CI1ITLJAMIl,\j1=.
<br /> ..., -
<br /> txo~ UA81l..fTY FAt":Hffr.I).I:lClCiNCG: . ?,SOO
<br />B LlURAf;II.4. ~OFlM ClM 3Oa-9S6B 511/94 bll/~~ AGGFlfGA.Tf . ?SM
<br /> X OTHER T"'A/II UMB!:lFII A !:'ng~ -" ..
<br /> "
<br /> WOnKl:n~ COM~E"'''TfO'' s:TilTUT(lRVLWlIiS
<br /> ... GTATE APPROVED !ACtI ACCIDENT . '.!W)
<br />N fMPLonR$. Ila_,ut'Y SELF INSURER 5/1/94 ~119G CWetMe..,.oucy UMIT . 2,500
<br />I m~,A.SE-E"CW EIAPL.O~ , .2,500
<br />A
<br />OTliER ..
<br />OQI;RIPTJON "I" (,WcHA.T10NSlL.OCATIONSNEHICU::sisPECIAL.ltEMS - ..-
<br /> DAn: I.5&UECI: OANCC:L.LA IIUN:
<br /> NAME AND AOORES~ m: t:FQTI!:'ICA:Te "'Ol.D'~ .HUULO ANY OF THE ABOVE DESCRIBEO POLICIES BE CANe~11 Fn
<br /> 6EFORE THE EXPIRATION DATE THEAEOF. THE ISSUING r:n"_ANY
<br /> WILL ENDEAVOR TO MAIL 3D DAYS WRITT~N NOTICE TO TH'
<br /> CERTIFICATE HOLDEA, BUT FAILURE Tn "A", SUCH NOTle'SHALL
<br /> IMPOSE NO OBLIGATION nR llARll.1TV OF ANY KINO UPON THE
<br /> COMPANY, ITS AGINT~ OR REPRESENTATIVES.
<br /> }'1t.<d. ! 4 .d.A~
<br /> ~UTt'I"RIZ~1I "t:"'I'f~t.N I A liVE
<br /> OertUl'.I...H..I",,,, (Yl'1I111l) OISulclF.IIlrtilOW) HOUlton F1i$!i: Mgm'l. IPiflk & Goldl ""
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