Laserfiche WebLink
Insurer: SENTINEL INSURANCE COMPANY, LIMITED tL ay <br />ONE HARTFORD PLAZA, HARTFORD, CT 06155 it <br />This Declarations Page, with Umbrella Liability Provisions and Endorsements, if any, issued to form a part thereof, <br />shall together constitute this Umbrella Liability Supplemental Contract, which in turn forms a part of Policy Number <br />shown below. <br />None of the provisions of the policy to which this Supplemental Contract is attached applies to the Umbrella Liability <br />Insurance provided hereunder. <br />Wherever the word "policy" appears in this form or in endorsements attached to or made a part of this Supplemental <br />Contract, it means "Supplemental Contract". <br />POLICY NUMBER: 59 SBA RV9040 <br />DECLARATIONS <br />Named Insured and Mailing Address: BAY SPROUTS LLC <br />SEE FORM SS 12 35 <br />6800 OWENSMOUTH AVE STE 350 <br />CANOGA PARK CA 91303 <br />Policy Period From: 11/13/20 To: 11/13/21 <br />12:01 A.M., Standard time at the address of the named insured as stated herein. <br />Premium $ INCLUDED ADVANCE PREMIUM <br />Self Insured Retention $10, 000 each occurrence <br />The Limits of Insurance subject to all the terms of this policy that apply are: <br />Each Occurrence $ 6,000,000 Products -Completed Operations Aggregate Limit $ 6,000,000 <br />General Aggregate Limit (Other $ 6,000,000 Bodily Injury By Disease Aggregate Limit $ 6,000,000 <br />than Products - Completed <br />Operations, Bodily Injury By <br />Disease and Automobile) <br />Schedule of Underlying Insurance Policies <br />See Attached "Extension Schedule of Underlying Insurance Policies" <br />Form Numbers of Forms and Endorsements that apply. <br />SX80041008 <br />SX02061008 <br />SX21050697 <br />SX21940317 <br />SX24580901 <br />SX80020405 <br />SX02420317 <br />SX21080405 <br />SX23151215 <br />SX01081008 <br />SX02460120 <br />SX21661008 <br />SX24010401 <br />SX02040118 <br />SX21040697 <br />SX21821008 <br />SX24330610 <br />Countersigned by`'"` �`�'�' 08/18/20 <br />Authorized Representative Date <br />Form SX 80 01 06 97 T Printed in U.S.A. (NS) <br />Process Date: 0 8 / 18 / 2 0 <br />ew cF RAMwagementDMsian <br />Jy/,'q REVIEWED & APPROVED BY.- <br />v <br />Policy Expiration Date: WskPjanagementftalpt <br />