CERTIFICATE OF INSURANCE

THIS IS TO CERTIFY TO:

____________________________________

(Landlord's name as it appears on lease)


8700 Dufferin Street

Concord, Ontario L4K 4S6

 

that Policy(ies) of insurance as herein described have been issued to the Insured named this date.

 

NAMED INSURED:

____________________________________

(Tenant's name as it appears on lease)

MAILING ADDRESS:

____________________________________

____________________________________

____________________________________


COVERAGE

Insurer & Policy

Limit

Policy Period

 

COMMERCIAL GENERAL LIABILITY

 

_________________

#________________

 

$_______________

 

___________to

___________

Including

- Products and Completed Operations

- Personal Injury

- Occurrence Form

- Blanket Contractual

- Cross Liability/Serverability of Interest Clause

- Non-Owned Automobile Liability

- Tenants Legal Liability (Broad Form)

 

 

 

 

 

 

 

 

 

_________________

#________________

 

$_____________

(Aggregate)

 

 

 

 

$_____________

 

 

 

 

 

 

 

__________ to

__________

ALL RISKS PROPERTY

- Including improvements, contents of every description

 

_________________

#________________

$_____________

__________ to

__________

 

BUSINESS INTERRUPTION

_________________

#________________

$_____________

__________ to

__________

 

THIRD PARTY LIABILITY

- Owned Vehicles

_________________

#________________

 

$_____________

__________ to

__________

 

UMBRELLA LIABILITY

- In Excess of Underlying Commercial General Liability and Third Party Automobile Liability Limits

_________________

#________________

$_____________

__________ to

__________

 


COVERING:

Risk Location: _______________________________________________________

Use of premises as: ___________________________________________________

NOTE:

It is agreed that _________________________________ (Landlord name as it appears on lease) is added as Additional Insured with respect to Commercial General Liability and Umbrella Liability and then only with respect to liability arising out of the operations of the Named Insured at the above noted project.

 

It is further agreed that _________________________________ (Landlord name as it appears on lease) will be given 30 days prior written notice of cancellation with respect to Commercial General Liability and Umbrella Liability and 15 days with respect to Third Party Liability (Owned vehicles), except where Statutory Conditions apply.

This Certificate ofInsurance does not in any way amend or alter the terms, conditions and exclusions of the policies mentioned above.

 

Dated:_________________________________________________________________________

 

 

at the office of:

________________________________________________

________________________________________________

________________________________________________

Tel:#___________________ Fax:#____________________

 

 

________________________________________________

(Authorized Reprezentative)