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THIS IS TO CERTIFY TO: |
____________________________________ (Landlord's name as it appears on lease) 8700 Dufferin Street Concord, Ontario L4K 4S6 |
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that Policy(ies) of insurance as herein described have been issued to the Insured named this date.
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NAMED INSURED: |
____________________________________ (Tenant's name as it appears on lease) |
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MAILING ADDRESS: |
____________________________________ ____________________________________ ____________________________________ |
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COVERAGE |
Insurer & Policy |
Limit |
Policy Period |
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COMMERCIAL GENERAL LIABILITY |
_________________ #________________ |
$_______________ |
___________to ___________ |
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Including - Products and Completed Operations - Personal Injury - Occurrence Form - Blanket Contractual - Cross Liability/Serverability of Interest Clause - Non-Owned Automobile Liability - Tenants Legal Liability (Broad Form)
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_________________ #________________ |
$_____________ (Aggregate)
$_____________ |
__________ to __________ |
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ALL RISKS PROPERTY - Including improvements, contents of every description
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_________________ #________________ |
$_____________ |
__________ to __________
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BUSINESS INTERRUPTION |
_________________ #________________ |
$_____________ |
__________ to __________
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THIRD PARTY LIABILITY - Owned Vehicles |
_________________ #________________
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$_____________ |
__________ to __________
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UMBRELLA LIABILITY - In Excess of Underlying Commercial General Liability and Third Party Automobile Liability Limits |
_________________ #________________ |
$_____________ |
__________ to __________
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COVERING: |
Risk Location: _______________________________________________________ Use of premises as: ___________________________________________________ |
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NOTE: |
It is agreed that _________________________________ (Landlord name as it appears on lease) is added as Additional Insured with respect to Commercial General Liability and Umbrella Liability and then only with respect to liability arising out of the operations of the Named Insured at the above noted project.
It is further agreed that _________________________________ (Landlord name as it appears on lease) will be given 30 days prior written notice of cancellation with respect to Commercial General Liability and Umbrella Liability and 15 days with respect to Third Party Liability (Owned vehicles), except where Statutory Conditions apply. |
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This Certificate ofInsurance does not in any way amend or alter the terms, conditions and exclusions of the policies mentioned above.
Dated:_________________________________________________________________________
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at the office of: |
________________________________________________ ________________________________________________ ________________________________________________ Tel:#___________________ Fax:#____________________
________________________________________________ (Authorized Reprezentative) |