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KATHRYN FORREST (3)
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Last modified
6/15/2022 12:11:07 PM
Creation date
5/27/2021 4:12:00 PM
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Template:
Contracts
Company Name
KATHRYN FORREST
Contract #
N-2021-115
Agency
Community Development
Expiration Date
6/30/2021
Destruction Year
2026
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Burns& <br />Wilcox <br />101 California Street, Suite 975, San Francisco, CA 94111 <br />Phone: (415) 421-4244 OR (800) 759-4855 Fax: (415) 421-0620 <br />DATE: 4/7/2021 INSURANCE BINDER Page 2 of <br />LIMITS / DEDUCTIBLES: <br />Loc Sub Coverage Limit(s) Deductible(s) Co Ins <br />1 General Aggregate $2,000,000 <br />1 Products and Completed Operations $2,000,000 <br />1 Each Occurrence $1,000,000 $500 Per Claim BI/PD <br />1 Personal and Advertising Injury $1,000,000 <br />1 Medical Expense / Any One Person $5,000 <br />1 Damage to Premises Rented to You / Each Occurrence $100,000 <br />TOTAL CHARGES: <br />Premium: $ <br />Fee: $ <br />Tax: $ <br />Tax: $ <br />TOTAL: $ <br />EXCLUSIONS: <br />600.00 Commercial General Liability <br />200.00 Brokerage Fee (Fully Earned) <br />1.50 Stamping Tax <br />18.00 Surplus Lines Tax - GenLiab <br />819.50 <br />SEE "ENDORSEMENTS" SECTION BELOW / NEXT PAGE <br />ENDORSEMENTS: <br />100% MINIMUM & DEPOSIT <br />MINIMUM RETAINED PREMIUM: <br />100.00 % EARNED <br />MINIMUM PREMIUM = $600.00 <br />y, RIaW maganenEDlWslon <br />REVIEWED&APPROVED BY: <br />s F,~44 P, U:@auE <br />V-�—' Risk Management Analyst <br />
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