45-010 (9) �s 0/0
MIIA PROPERTY AND CASUALTY GROUP, INC.
CERTIFICATE OF INSURANCE DATE(MM/DD/YYYY)
07/0112018
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE CONTRACTS BELOW.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the contract(s) must be endorsed. A statement on this certificate
does not confer rights to the certificate holder in lieu of such endorsement(s).
INSURED PRODUCER
City of Northampton MIIA Member Services
210 Main Street Department 530, P.O. Box 4106
Northampton, MA 01060 Woburn, MA 01888-4106
COVERAGES CERTIFICATE NUMBER: 35 REVISION NUMBER:
THIS IS TO CERTIFY THAT CONTRACTS OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE
CONTRACT PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT
WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE CONTRACTS
DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS,AND CONDITIONS OF SUCH CONTRACTS.
INSR ADDL CONTRACT EFF CONTRACT EXP
LTR TYPE OF INSURANCE INSD CONTRACT NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
X COMMERCIAL GENERAL LIABILITY Each Occurrence $1,000,000
CLAIMS-MADE X❑ OCCUR Damage To Rented Premises(Ea $100,000
occurrence)
Med Exp(Any one person) $5,000
A NOR00128-03-18 07/012018 07/0112019 Personal&Adv Injury $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER
LOCATION General Aggregate $3,000,000
Products-Comp/Op Agg $3,000,000
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
HIRED AUTOS NON-OWNED
AUTOS
UMBRELLA LIAB OCCUR
EXCESS LIAR CLAIMS-
MADE
DED RETENTIONS
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
OFFICER/MEMBER INCLUDED? NIA
(Mandatory In NH)
If yes,describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required)
PROOF OF COVERAGE WITH RESPECTS TO SMITH VOC PROJECT FROM NOVEMBER 1ST.2018 TO JANUARY 1,2019 ON AUDUBON'S PROPERTY-123 COMBS ROAD,NORTHAMPTON,MA.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED CONTRACTS BE CANCELLED BEFORE THE
LN ARCADIA WILDLIFE SANCTUARY EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS
WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO MAIL
12AD SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
EMA 01027 COMPANY,ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE