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URBANA OP ID: MB <br /> CERTIFICATE OF LIABILITY INSURANCE 1 DATE 02/05D/YYYY) <br /> 2ro5r1 s <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to <br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> CONTACT <br /> PRODUCER <br /> 412-271-8888 NAME: Russell W.Shields <br /> Thompson-Gusic Insurance Group 412-271-8898 PHONE 412-271-8888 FAX <br /> 4067 Greensburg Pike A/c No El):412-271-8888 A/C No):412-271-8898 <br /> Pittsburgh,PA 15221 ADDRESS:Russell W.Shields michelle thompsongusic.com <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:Donegal Mutual 13692 <br /> INSURED Urban Design Ventures, LLC. INSURER B:CNA Insurance Co i20443 <br /> 212 E 7th Avenue <br /> Homestead, PA 15120 INSURERC: <br /> INSURER D: <br /> INSURER E. <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR 1 ADDL SUBFj POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE POLICY NUMBER MMIL[I YY MM/DD/YYYY I LIMITS <br /> GENERAL LIABILITY <br /> _ EACH OCCURRENCE S 1,000,00 <br /> A X COMMERCIAL GENERAL LIABILITYBOP8019766 05!11/17 ! 05/11/18 -DDA�M �B'1'b—R�i3T`ED <br /> f PREMISES Ea occurrence S 50,00 <br /> CLAIMS-MADE OCCUR i MED EXP(Any one person) 5,00 <br /> B 'i X Professional _ 1254090920 1 01/03/18 01/03/19 !�PERSONAL s ADV INJURY_ IS 1,000,00 <br /> Li ! j GENERAL AGGREGATE S 2,000,00 <br /> I GEN'L AGGREGATE LIMIT APPLIES PER: ! I PRODUCTS-COMP/OP AGG ($ 2,000,00 <br /> POLICY i PRO I j ( P Or fessio s — 500,00 <br /> AUTOMOBILE LIABILITY I j ' COMBINED SINGLE LIMIT <br /> 1 Eaaccident is 1,000,00 <br /> A X ANY AUTO CA8019766 11119/17 11/19/18 BODILY INJURY(Per person) T S <br /> r^ALL OWNED ' SCHEDULED ~BODILY INJURY(Per accident)i$ <br /> AUTOS 1 AUTOS <br /> NON-OWNED ( PROPERTY DAMAGE <br /> HIRED AUTOS AUTOS j (Per accident) S <br /> �--) UMBRELLA LIAB OCCUR EACH OCCURRENCE 1 $ <br /> I I EXCESS LIAB j CLAIMS-MADE (_AGGREGATE i S <br /> DED RETENTION S S <br /> WORKERS COMPENSATION i WC STATU- 'OTH <br /> AND EMPLOYERS'LIABILITY Y/N _ j I i TORY LIMITS( ( ER <br /> A ANY FICER/MEMBER RIETOR EXCLUDED?ECUTIVE ❑ N/A WC8019766 10/30/17 I 10/30/18 ,E. EACH ACCIDENT S 100,00 <br /> OFI <br /> (Mandatory in NH) ( E.L.DISEASE-EA EMPLOYEEI,$ 100,00 <br /> 1 If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1 S 500,00 <br /> I j i I <br /> i <br /> DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Proof of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> Russell W.Shields <br /> ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD <br />