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HAASE, MADELEINE L
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8/11/2011 5:45:00 PM
Creation date
6/1/2011 1:47:56 PM
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Insurance
General 2 - Date
2/11/2010
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RightFax 4/14/2011 1:02 PACE 3/4 Fax Server <br /> Avernco Insurance Company <br /> 411 Aviation W Suite 100 <br /> Frederick, MD 21701 <br /> CERTIFICATE OF INSURANCE <br /> THIS CERTIFICATE IS ISSUED TO: Date: 06101/2010 <br /> Rive rslde Municipal Airport <br /> and City of Riverside <br /> 6951 Flight Rd <br /> Rlverside, CA 92504 <br /> -- DESCRIPTIVE S,QHEDLF -- <br /> POLICYHOLDER: ...........,.,.,.,_...., <br /> Madeleine L. Haase <br /> 15790 RM <br /> 1 5790 Rancho Viejo D <br /> Riverside, CA 92506 <br /> POLICY NUMBER: 990103153019 <br /> POLICY From 06/30/2010 To: 46129/2411 <br /> PERIOD <br /> 12:00:01 A.M. 11:59:59 P.M. (local time at policyho'der's address) <br /> INSURED AIRCRAFT: 30470 1 993 SUD ION SOCATA TB 9 TAMP IGO <br /> LIMITS OF LIABILITY: (125401) <br /> LIABILITY — Bodily Injury $ 100,000 each person <br /> (including Occupants) <br /> and Property Damage $ 1,000,000 property damage <br /> $ 1 ,000 ,000 each accident <br /> The most current date shown In the top right corner is the most current certificate for this insured property, <br /> and replaces all certificates, if any, previously issued under this Policy number or any other Policy number. <br /> This Certificate of Insurance neither affirmatively nor negatively amends, extends or alters the coverage <br /> afforded by the Policy. !t is issued as a matter of Information only and confers no rights upon the certificate <br /> hold a r. <br /> Avemco Insurance Company <br /> DISTRIBUTION: 0. <br /> Certificate Holder Authorized Representative <br /> Policyholder <br /> NG�F1 -1254 <br /> Copy for your records <br />
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