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    Evidence of Coverage 2022 - 2023

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    Wyatt Wilson
    The document is a certificate of liability insurance for On the Fly Productions LLC that provides coverage from May 23, 2022 to May 23, 2023. It lists various types of insurance policies including commercial general liability, automobile liability, umbrella liability, workers compensation, and inland marine. Limits and policy numbers are specified for each.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Evidence of Coverage 2022 - 2023

    Uploaded by

    Wyatt Wilson
    166 views1 page
    The document is a certificate of liability insurance for On the Fly Productions LLC that provides coverage from May 23, 2022 to May 23, 2023. It lists various types of insurance policies including commercial general liability, automobile liability, umbrella liability, workers compensation, and inland marine. Limits and policy numbers are specified for each.

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    Evidence of Coverage 2022_2023

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    © © All Rights Reserved

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    The document is a certificate of liability insurance for On the Fly Productions LLC that provides coverage from May 23, 2022 to May 23, 2023. It lists various types of insurance policies including commercial general liability, automobile liability, umbrella liability, workers compensation, and inland marine. Limits and policy numbers are specified for each.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    166 views1 page

    Evidence of Coverage 2022 - 2023

    Uploaded by

    Wyatt Wilson
    The document is a certificate of liability insurance for On the Fly Productions LLC that provides coverage from May 23, 2022 to May 23, 2023. It lists various types of insurance policies including commercial general liability, automobile liability, umbrella liability, workers compensation, and inland marine. Limits and policy numbers are specified for each.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    DATE (MM/DD/YYYY)

    CERTIFICATE OF LIABILITY INSURANCE 06/02/2022


    THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
    CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
    BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
    REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
    IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
    If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
    this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
    PRODUCER CONTACT Beth Carulli-Weiner
    NAME:
    Taylor & Taylor Ltd. PHONE (212) 490-8511 FAX (212) 490-7236
    (A/C, No, Ext): (A/C, No):
    271 Madison Avenue E-MAIL ecarulli@taylorinsurance.com
    ADDRESS:
    INSURER(S) AFFORDING COVERAGE NAIC #
    New York NY 10016-1001 INSURER A : New York Marine and General Insurance Company 16608
    INSURED INSURER B :
    On the Fly Productions LLC INSURER C :
    c/o Donova, Roseman & Renfro LLC INSURER D :
    12412 Powerscourt Drive, #35 INSURER E :
    St. Louis MO 63131 INSURER F :
    COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
    THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
    INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
    CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
    EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
    INSR ADDL SUBR POLICY EFF POLICY EXP
    LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
    COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
    DAMAGE TO RENTED 100,000
    CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $

    MED EXP (Any one person) $ 5,000


    A PK202200017761 05/23/2022 05/23/2023 PERSONAL & ADV INJURY $ 1,000,000

    GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000


    PRO- 1,000,000
    POLICY JECT LOC PRODUCTS - COMP/OP AGG $

    OTHER: $

    AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $


    (Ea accident)
    ANY AUTO BODILY INJURY (Per person) $
    OWNED SCHEDULED BODILY INJURY (Per accident) $
    AUTOS ONLY AUTOS
    HIRED NON-OWNED PROPERTY DAMAGE $
    AUTOS ONLY AUTOS ONLY (Per accident)
    $

    UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000


    A EXCESS LIAB CLAIMS-MADE UM202200010964 05/23/2022 05/23/2023 AGGREGATE $ 1,000,000

    DED 10,000
    RETENTION $ $
    WORKERS COMPENSATION PER OTH-
    AND EMPLOYERS' LIABILITY STATUTE ER
    Y/N
    ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000
    A OFFICER/MEMBER EXCLUDED? N N/A WC202100021846 10/28/2021 10/28/2022
    (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000
    If yes, describe under
    DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000
    LIMIT $95,000
    INDLAND MARINE
    A (Miscellaneous Owned Equipment) PK202200017761 05/23/2022 05/23/2023 DEDUCTIBLE $ 1,000
    COINSURANCE 90%
    DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

    ***COVERING OPERATIONS OF THE NAMED INSURED. EVIDENCE ONLY***

    CERTIFICATE HOLDER CANCELLATION

    SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE


    THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
    ***Evidence of Coverage*** ACCORDANCE WITH THE POLICY PROVISIONS.

    AUTHORIZED REPRESENTATIVE

    © 1988-2015 ACORD CORPORATION. All rights reserved.


    ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD

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