Common Contracts
1 similar Certificate of Insurance contracts
ContractCertificate of Insurance • April 8th, 2014
Capital Contract Operating Contract All Other Agreements Metropolitan Transportation AuthorityCERTIFICATE OF INSURANCE (For Joint Agency Agreements) AGREEMENT or CONTRACT #: AGREEMENT or CONTRACT NAME/DESCRIPTION: Producer: ADDRESS:PHONE #: CERTIFICATE ISSUANCE DATE: DATE RECEIVED: MTA REFERENCE #: INSURED: ADDRESS: PHONE #: CO LTR COMPANIES AFFORDING COVERAGE A NAIC # B NAIC # C NAIC # CERTIFICATE HOLDER: ADDRESS: PHONE #: Metropolitan Transportation Authority Attention: Risk & Insurance Management 2 Broadway 21st FloorNew York, NY 10004 (646) 252-1425 D NAIC # E NAIC # F NAIC # G NAIC # COVERAGES (See Notes 1 and 2) CO LTR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE LIMITS GENERAL LIABILITYCommercial General Liability Form Underground Expl.& Collapse Hazard Products/Completed Operations Contractual LiabilityIndependent ContractorsFifty Foot Exclusion Removed Personal & Advertising Injury SIR/Deductible $ BI & PD COMBINED OCCURRENCE
