DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 11/26/2024
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 have ADDITIONAL INSURED provisions or 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: GREAT WEST SERVICES INC
RELIANCE PARTNERS LLC (TN) - 0632-SC PHONE FAX
555 WALNUT ST STE 400 (A/C, No, Ext): 888-603-6063 (A/C, No): 402-494-7480
E-MAIL
CHATTANOOGA TN 37402 ADDRESS:
[email protected] INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A : GREAT WEST CASUALTY COMPANY 11371
INSURED INSURER B :
INFINITY FREIGHT SYSTEM INC
9835 W 56TH ST APT 3W INSURER C :
COUNTRYSIDE IL 60525 INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 1099569778 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
A X COMMERCIAL GENERAL LIABILITY GRT32382A 11/11/2024 11/11/2025 EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED
CLAIMS-MADE X OCCUR PREMISES (Ea occurrence) $ 100,000
MED EXP (Any one person) $ 5,000
PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
X POLICY PRO-
JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000
OTHER: $
A COMBINED SINGLE LIMIT $ 1,000,000
AUTOMOBILE LIABILITY GRT32382A 11/11/2024 11/11/2025 (Ea accident)
ANY AUTO BODILY INJURY (Per person) $
OWNED
AUTOS ONLY
X SCHEDULED
AUTOS
BODILY INJURY (Per accident) $
NON-OWNED
X HIRED
AUTOS ONLY
X AUTOS ONLY
PROPERTY DAMAGE
(Per accident) $
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION $ $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS' LIABILITY STATUTE ER
Y/N
ANYPROPRIETOR/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 CARGO LIABILITY - BROAD FORM GRT32382A 11/11/2024 11/11/2025 PER AUTO/DEDUCTIBLE $150,000/$2,500
A TRAILER INTERCHANGE GRT32382A 11/11/2024 11/11/2025 LIMIT/DEDUCTIBLE $50,000/$2,500
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Broad Form Includes Mechanical Reefer Breakdown.
CERTIFICATE HOLDER CANCELLATION
Nationwide Transportation and Logistics Services, Inc. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
5940 Nieman Rd ACCORDANCE WITH THE POLICY PROVISIONS.
Shawnee, KS 66203 AUTHORIZED REPRESENTATIVE
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
