Laserfiche WebLink
Markel Insurance Company <br />POLICY NUMBER: MTU70002501-00 EXCESS/UMBRELLA <br />PREVIOUS POLICY NUMBER: NEw MD 067 -FL 08 03 <br />EXCESS/UMBRELLA DECLARATIONS <br />Named Insured and Mailing Address: Agent's Named and Mailing Address: <br />Coastal Health Systems of Brevard Inc Cindy Elbert Insurance Services <br />486 Gus Hipp Blvd. 15182 N 75th Ave #100 <br />Rockledge, FL 32955 Peoria, AZ 85381 <br />Producer Number: AZ15070K <br />Policy Period From: 5/27/13 To: 5/27/14 <br />At 12:01 a.m. standard time at your mailing address shown above <br />This policy provides W Excess Liability coverage only or U Umbrella Liability coverage only. <br />Only the policy provisions applicable to the type of coverage checked in the above box will apply. Please <br />refer to the WSPROYe sections of the polky for what is and is not covered pccording to the coverage <br />In return for the payment of the premium and subject to all the terms of this policy, we agree to provide the insurance as <br />stated in this policy. <br />Policy Premium: $18, 595.00 <br />Direct Billed Agency Billed <br />Limits of Insurance: <br />General Aggregate $ 1,000,000 <br />Products -Completed Operations Aggregate $ 1,000,000 <br />Each Occurrence $ 1,000,000 <br />Each Person — Personal and Advertising Injury $ 1,000,000 <br />Self Insured Retention — Each Occurrence $ 10,000 <br />Forms and Endorsements attached to this policy at time of issuance: <br />SEE SCHEDULE OF FORMS AND ENDORSEMENTS <br />Issue Date: May 31, 2013 At: Kennesaw, GA By: Greg Thompson <br />Authorized Representative) <br />MD 067 -FL 08 03 Copyright, Markel Insurance Company, 2003 Page 1 of 4 <br />90 <br />