Certificate of Liability InsuranceJul 11 2006 12:59PM United Agencies Insurance 216-241-1339
P.1
ACORD
. CERTIFICATE OF LIABILITY INSURANCE
PROBER THIS CERTIFICATE IS ISSUED AS A MATTER OF
United Agencies Insurance Group ONLY AND CONFERS NO NIGHTS UPON THE
Donald J. Mada HOLDER. THIS CERTIFICATE DOES NOT E IC
ALTER THE COVERAGE AFFORDED BY THE POL
1422 Euclid Ave, #900
Cleveland, OH 44115.2001 INSURERS AFFORDING COVERAGE
INSURED Kalispell Hotel, LLC INSURER A, PHILADELPHIA INSURANCE CO
CIO Western Hospitality Group LP INSURER B: American International Specialty
3720 N. Reserve Street INSURER C:
Missoula, MT 59808 INSURER ❑:
DATE DIYYYY)
07/11/2006
NFORMATION
CERTIFICATE
EXTEND OR
CIES BELOW.
NAIC 9
THE POLICES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTATrHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS.
I
0-
MM19EINSURANCELIMITS
PCILdCYNUMBER
POLTCYEFFECTritE
PW.JCYEXPiRAT
A
X
GENERALLIABILITY
PHPK790461
01/05106
10/01/06
EACH OCCURRENCE
$ 1.000 0.
DAMAGE TO PREMISE E�
ffi 100.000
COMMERCIAL GENERAL �- -L-I�ABILITY
CLAIMS MADE LS 1 OCCUR
M.ED J' {P (Any one pamn)
$ 5 d0i:.
PERSONAL& AOV INJURY
$ 1,000,000.
X Terrorist Included
X
Liq,Uor LlailiY
GENERAL AGGREGATE
$ 000 000.
(3ENLAGGREGATE LIMITAPPLIES PER-
PRODUCTS-COMPIOPAGG
S 2000000.
POLICY t�O- LOC
A
AUTOWBU
LIABILITY
ANY AUTO
PH PK790461
01/05/06
10/01/06
COMBINED SINGLE LMrr
(Ea )
$ 000 000.
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
Ter —den!)
$
HIRED AUTOS
N0N•OWNEDAUTOS
X
PROPERTY DAMAGE
(Per acd lmd)
b
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
Bi
OTHERTHAN EA ACC
$
ANYAUTO
$
AUTOONLY: AGG
B
EXCESSIUMBRELLAURBILITY
771140 854
01/05/06
10/01/06
EACH OCCURRENCE
$ 25 000 000.
OCCUR CLAIMS MADE
AGGREGATE
S 25 DW0W.
S
$
DEDUCTIBLE
$
RETENTION 5 10 000
WORKERSCOMPENSATIDNANO
EMPLOYERS' LBABIUTY
ANY PROPREiORIPARTHERIEXECUTIVE
OFFICERNIEMSFREXCLUDED?
WCSTATU} OTH-
TORYLIMITS R
E.L. EACH ACCIDENT
$
E.L. DISEASE -EA EMPLOYEE
$
If miler
SPECIAL PROVISIONS below
E.L. DISEASE-POLICYLIMIT IS
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT f SPECIAL PROVISKM
RE: Hotel site an U. S. Highway 93 (18th and 20th Streets) Kalispell, MT
City Of Kalispell, Montana
ATTN: City Manager
P, 0. Sox 1997
Kalispell, MT 59903-1977
25120011081
SHOULD ANY OF THE ABOVE DESCRU3ED POLICES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WALL ENDEAVOR TO MAIL 30 DAYS WRnTm
NOTICE TO TIRE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILWM TO 00 30 STHALL
IMPOSE NO OBILIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
AUTMIM2E1) REPRESENTATIVE
i