THIS IS TO CERTIFY TO: |
(Landlord's name as it appears on lease)
123 Any Street City, Ontario A1B 2C3 |
that Policy(ies) of insurance as herein described have been issued to the Insured named this date. |
|
NAMED INSURED: |
(Tenant's name as it appears on lease)
|
MAILING ADDRESS: |
______________________________________________ ______________________________________________ |
COVERAGE |
Insurer & Policy |
Limit |
Policy Period |
COMMERCIAL GENERAL LIABILITY |
_________________ #________________ |
$_______________ |
____________ to ____________ |
Including - Products and Completed Operations - Personal Injury - Occurrence Form - Blanket Contractual - Cross Liability/Severability of Interest Clause - Non-Owned Automobile Liability - Tenants Legal Liability (Broad Form)
|
_________________ #________________ |
$_______________ (Aggregate)
$_______________ |
____________ to ____________ |
ALL RISKS PROPERTY - Including improvements, contents of every description |
_________________ #________________ |
$_______________ |
____________ to ____________ |
BUSINESS INTERRUPTION |
_________________ #________________ |
$_______________ |
____________ to ____________ |
THIRD PARTY LIABILITY - Owned Vehicles |
_________________ #________________ |
$_______________ |
____________ to ____________ |
UMBRELLA LIABILITY - In Excess of Underlying Commercial General Liability and Third Party Automobile Liability Limits |
_________________ #________________ |
$_______________ |
____________ to ____________ |
COVERING: |
Risk Location: UNIT |
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. |
This Certificate of Insurance does not in any way amend or alter the terms, conditions and exclusions of the policies mentioned above. Dated this _________ day of __________________ 20______ at the office of:
________________________________________________________ _________________________________ |