2000-02-28 Regular Meeting - Laserfiche WebLink

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,.' e e )~ SCOTTSDALE INSURANCE COMP~ COMMERCIAL GENERAL LIABILITY COVERAGE PART SUPPLEMENTAL DECLARATIONS Policy No. CPS0279401 Effective Date Named Insured LA PORTE BAY AREA HERITAGE Agent No. 05/09/1999 12:01 A.M., Standard Time 42002 .. Item 1. Limits of Insurance Coverage Limit of Liability Aggregate Limits of Liability Products/Completed $ 500,000 Operations Aggregate General Aggregate (other than $ 500,000 Products/Completed Operations) Coverage A - Bodily Injury and anyone occurrence subject Property Damage Liability to the Products/Completed ., Operations and General $ 500,000 Aggregate Limits of Liability anyone premises subject to the Coverage A occurrence and , the General Aggregate Limits Damage to Premises Rented to You Limit $ 100,000 of Liability Coverage B - Personal and anyone person or organization Advertising Injury Liability subject to the General Aggregate . $ 500,000 Limits of Liability Coverage C - Medical Payments anyone person or subject to the Coverage A occurrence and the General Aggregate Limits $. 5,000 of Liability Item 2. Form of Business and Location of Premises Form of Business: 0 Individual o Partnership or Joint Venture o Limited Liability Company C!I Organization (other than Partnership, Joint Venture or Limited Liability Company) Location of All Premises You Own, Rent or Occupy: 910 PARK, LA PORTE, TX 77572 Item 3. Forms and Endorsements Form(s) and Endorsement(s) made a part of this policy at time of issue: See Schedule of Forms and Endorsements Item 4. Premiums Coverage Part Premium: $ 250 Other Premium: $ Total Premium: $ 250 \ ~ THESE DECLARATIONS ARE PART OF THE POLICY DECLARATIONS CONTAINING THE NAME OF THE INSURED AND THE POLICY PERIOD. CLS-8D-1L (9-98) INSURED