Standard Consultant Certificate of Insurance

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					                                                                                Certificate of Insurance
                                                                                    Standard Form
This certifies that policies of insurance as described below have been issued to the Insured named below and are in full force and effect at this time. It is
understood and agreed that thirty (30) days' written notice of cancellation or reduction in applicable limit of insurance of any of the policies listed below,
with the exception of ICBC, will be given to the holder of this certificate.

NOTE:         INSURANCE COMPANIES MUST BE LICENSED TO OPERATE IN CANADA.

This Certificate is issued to: The City of Surrey, 14245 - 56 Avenue, Surrey, B.C. V3X 3A2
Insured:      Name:        Click here to enter text.
                Address:     Click here to enter text.

Broker:         Name:        Click here to enter text.                              Agent’s Name:    Click here to enter text.
                Address:     Click here to enter text.                                    Phone:     Click here to enter text.

Location, Project No. and nature of contract, permit, lease, license or operation to which this Certificate applies:

Click here to enter text.




                                                                                             Policy Term
Type of Insurance                                    Company and Policy Number               yyyy/mm/dd                    Limits of Liability/Amount
Section 1                                                                                                          Bodily Injury, Death & Property Damage
                                                                                         From: Click here to       $Click here to enter text.
Commercial General Liability                    Click here to enter text.                enter a date.
                                                                                         To:      Click here to    Per Occurrence $Click here to enter text.
                                                                                         enter a date.
__________ ___________                          ____________________                     ___________               General Aggregate $Click here to enter text.
                                                                                         From: Click here to
   Umbrella Liability                           Click here to enter text.                enter a date.             Products & Completed Operations
_____________________                           _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _   To:     Click here to     Aggregate $Click here to enter text.
                                                                                         enter a date.
      Excess Liability                          Click here to enter text.                ___________               Umbrella Limit
                                                                                                                   $Click here to enter text. Excess Limit
                                                                                         From: Click here to       $Click here to enter text. Deductible
                                                                                         enter a date.                        MINIMUM $5,000,000
                                                                                         To:     Click here to
                                                                                         enter a date.
Section 2                                                                                From: Click here to       Bodily Injury & Property Damage
Automobile Liability (owned or leased           Click here to enter text.                enter a date.             $Click here to enter text.   Limit
vehicles)                                                                                To:      Click here to                MINIMUM $3,000,000
                                                                                         enter a date.
Section 3                                                                                From: Click here to
Other:                                          Click here to enter text.                enter a date.             $Click here to enter text.      Limit
                                                                                         To:      Click here to    $Click here to enter text.      Deductible
                                                                                         enter a date.

                            Particulars of General Liability Insurance (Sections 1): X indicates that the coverage is included.
   City of Surrey as Additional Insured                        Broad Form Property Damage                    Broad Form Tenants Legal Liability
   Premises & Operations                                       Incidental Medical Malpractice                Advertising Liability
   Broad Form Products & Completed Operations                Personal Injury                                Host Liquor Liability
   Owners & Contractors Protective                             Use of explosives for blasting                Intentional Injury
                                                                Vibration from pile driving or caisson        Volunteers as Additional Insureds
   Blanket Contractual
                                                                                                              Members as Additional Insureds
                                                                work
   Cross Liability/Severability of Interests
                                                                Removal or weakening of support of            Injury to Participants (sporting events)
   Employees Additional Insureds                               property, building or land whether the        Aviation Liability
   Non-Owned Automobile                                        support is natural or otherwise               Non-owned aircraft liability
   Attached Machinery                                          Work below ground level over 3 meters         Watercraft liability
   Occurrence Property Damage                                  (XCU extension)                               Non-owned watercraft liability
   Contingent Employer’s

It is understood and agreed any deductible or reimbursement clause contained in the policy shall be the sole responsibility of the Named Insured.


                  (Authorized to Sign on Behalf of Insured)                                                            Date Signed



     (Authorized to Sign on Behalf of Insurers) and Brokers Stamp                                                      Date Signed



Jun 1, 2010

				
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