Registry Monitoring Insurance Services, Inc.

DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 12/16/2023

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
CONTACT
PRODUCER
NAME: Operations Department
PHONE FAX
Marquee Insurance Group LLC (A/C, No, Ext): 678-483-8151 (A/C, No): 678-483-8152
E-MAIL
1000 Holcomb Woods Pkwy ADDRESS: [email protected]
Suite 315-A INSURER(S) AFFORDING COVERAGE NAIC #
Roswell GA 30076 INSURER A : Canal Insurance Co. 10464
INSURED INSURER B :
BM TRUCK SYSTEMS LLC INSURER C :
115 EAST SKYLINE VIEW INSURER D :
INSURER E :
Dallas GA 30157 INSURER F :
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $
DAMAGE TO RENTED
CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $
MED EXP (Any one person) $
PERSONAL & ADV INJURY $

GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
PRO-
POLICY JECT LOC PRODUCTS - COMP/OP AGG $
OTHER: $
COMBINED SINGLE LIMIT
AUTOMOBILE LIABILITY (Ea accident) $ 1,000,000
ANY AUTO BODILY INJURY (Per person) $
ALL OWNED SCHEDULED
A AUTOS ✖ AUTOS TBD 12/18/2023 12/18/2024 BODILY INJURY (Per accident) $
NON-OWNED PROPERTY DAMAGE $
HIRED AUTOS AUTOS (Per accident)
UM PD $ 25,000
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION $ $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS' LIABILITY STATUTE ER
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
A Motor Truck Cargo TBD 12/18/2023 12/18/2024 Limit: $100,000, Deductible: $1,000
A Physical Damage TBD 12/18/2023 12/18/2024 Deductibles - Comp: $1,000, Coll: $1,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
A: Reefer Breakdown Liability ($2,500 Deductible). Effective Date: '12/18/2023', Expiration Date: '12/18/2024'
A: 'UM BI' With Limit '$25,000/$50,000'. Effective Date: '12/18/2023', Expiration Date: '12/18/2024'
Vehicles: [See Attached];
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Registry Monitoring Insurance Services, Inc.
1444 S Entertainment Ave Ste 110 AUTHORIZED REPRESENTATIVE
Boise ID 83709
© 1988-2014 ACORD CORPORATION. All rights reserved.

ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID:
LOC #:
ADDITIONAL REMARKS SCHEDULE Page 2 of 2
AGENCY NAMED INSURED
Marquee Insurance Group LLC BM TRUCK SYSTEMS LLC

POLICY NUMBER 115 EAST SKYLINE VIEW
TBD
CARRIER NAIC CODE Dallas, GA, 30157
Canal Insurance Co. 10464 EFFECTIVE DATE: 12/18/2023
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE
Vehicles:
2013, Great Dane, VIN: 1GRAA0624DE700869, ($25000.0)
2015, Wabash, Refrigerated Van, VIN: 1JJV532B8FL839609, ($25000.0)
2005, Freightliner, CONVENTIONAL, VIN: 1FUJA6CK05LM71081, ($20000.0)
2017, Freightliner, Cascadia, VIN: 3AKJGLDRXHSJD3877, ($25000.0)
ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

Registry Monitoring Insurance Services, Inc.

Uploaded by

Copyright:

Available Formats

Registry Monitoring Insurance Services, Inc.

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Registry Monitoring Insurance Services, Inc.

Uploaded by

Copyright:

Available Formats

DATE (MM/DD/YYYY)

CERTIFICATE OF LIABILITY INSURANCE 12/16/2023

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

Vehicles: [See Attached];

CERTIFICATE HOLDER CANCELLATION

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

© 1988-2014 ACORD CORPORATION. All rights reserved.

ADDITIONAL REMARKS SCHEDULE Page 2 of 2

AGENCY NAMED INSURED

Marquee Insurance Group LLC BM TRUCK SYSTEMS LLC

ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved.

You might also like