Laserfiche WebLink
COMMON POLICY DECLARATIONS <br />Pollcy Number GLO 91.57444-00 Renewal of Number NEW <br />Named Insured and Mailing Address Producer and Mailing Address <br />LSA ASSOCIATES, INC. DEALEY, RENTON & ASSOC <br />PO BOX 12675 <br />OAKLAND CA 94604-2675 <br />Producer Code 09181-000 <br />Pollcy Period: Coverage begins 09-30-07 at 12:01 A.M.; Coverage ends 09-30-08 at 12:01 A.M. <br />The named insured is El Individual ❑ Partnership Corporation <br />❑ Other: <br />This insurance is provided by one or more of the stock insurance companies which are members of the Zurich -American Insurance Group. The <br />company that provides coverage is designated on each Coverage Part Common Declarations. The company or companies providing this <br />Insurance may be referred to in this policy as 'The Company', we, us, or our. The address of the companies of the Zurich -American insurance <br />Group are provided on the next page. <br />THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE(S): <br />GENERAL LIABILITY COVERAGE PREMIUM; t ;) <br />issued by ZURICH AMERICAN INSURANCE COMPANY �= _,....,.......' <br />THIS PREMIUM MAY BE SUBJECT TO AUDIT. TOTAL $ 'k <br />This premium does not include Taxes and Surcharges. SEE INSTALLMENT SCHEDULE <br />Taxes and Surcharges TOTAL $ <br />The Form(s) and Endorsement(s) made a part of this policy at the time of issue are listed on the SCHEDULE of <br />FORMS and ENDORSEMENTS. <br />Countersigned this day of <br />Authorized Representative <br />THESE DECLARATIONS TUGtI Ht=H VVI I H I Fit UUMPAUN t'ULIUY wrvui i ivtva, l VvCnAuc rent vcvv+nni I i <br />FORM(S), FORMS AND ENDORSEMENTS, IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY. <br />U -GU -D -365-A (03/94) <br />ACENT COPY Page 1 of i <br />V/ <br />