INSURANCE STATEMENT. Our obligations are guaranteed by an insurance policy (No. 3312) issued by Virginia Surety Company, Inc. In the event that We, cease to operate, are bankrupt, or fail to pay an authorized claim within sixty (60) days after proof of loss is filed, You may file a claim directly with Virginia Surety Company, Inc., 000 Xxxx Xxxxxxx Xxxx., Chicago, IL 60604 (800) 209-6206.
INSURANCE STATEMENT. This is not an insurance policy. Our obligations under this Agreement are insured under an insurance policy issued by Riverpoint Reinsurance, LTD 18 The Village at Grace Bay Providenciales Turks and Caicos Islands Registration Number I.47341 License Number 12046/18 at 000-000-0000 In California, if any promise made in the Agreement has been denied or has not been honored within sixty (60) days after Your request, You may contact the California Department of Insurance at (000) 000-0000 or access the department's Internet Web site (xxx.xxxxxxxxx.xx.xxx). In the event the Obligor fails to pay an authorized claim within sixty (60) days after proof of loss has been filed, You may file a direct claim with Strategic Administration Group P.O. Box 161126 Fort Worth, Texas 76161 at (000) 000-0000 To do so, please call the following toll-free number for instructions: (000) 000-0000 N. DISPUTE RESOLUTION/ARBITRATION AGREEMENT AND CLASS ACTION WAIVER PLEASE READ THIS DISPUTE RESOLUTION/ARBITRATION Agreement AND CLASS ACTION WAIVER, INCLUDING THE OPT-OUT PROVISION, CAREFULLY TO UNDERSTAND YOUR RIGHTS. IT REQUIRES THAT CLAIMS (AS DEFINED BELOW) BE RESOLVED SOLELY THROUGH BINDING ARBITRATION ON AN INDIVIDUAL BASIS, RATHER THAN BY A JURY OR IN A CLASS ACTION. SAMPLE
INSURANCE STATEMENT. Occupant acknowledges that Owner does not provide insurance covering Occupant's stored property OCCUPANT WILL PURCHASE INSURANCE OR PROVIDE PROOF OF INSURANCE. Occupant agrees that they have read and understand the complete Insurance Paragraph, item # 12.
INSURANCE STATEMENT. Landlords must either complete this form or attach a statement containing the same information. Address of tenancy 0 Xxxxxxxx Xxxxx There is insurance covering this rental property that is relevant to tenant’s liability for damage to premises, including damage to body corporate facilities. Yes No The table below specifies the excess amounts of all relevant insurance policies for this property. Name/type of policy Insurer Excess amount
INSURANCE STATEMENT. I understand that it is my responsibility to obtain appropriate medical insurance coverage, and/or provide payments for all costs that may arise as a result of injury or damage related to my participation in this activity.
INSURANCE STATEMENT. Our obligations to perform under this Agreement are insured under an insurance policy issued by Xxxxxx Southern Insurance Company [00000 Xxxxxxxx Xxxx Xxxx., Xxx. 000, Xxxxxxxxxxxx, XX 00000, Tel: (000) 000-0000], except in Georgia, New York and Wisconsin. In Georgia, the Obligor is insured under an insurance policy issued by Insurance Company of the South [00000 Xxxxxxxx Xxxx Xxxx., Xxx. 000, Xxxxxxxxxxxx, XX 00000, Tel: (000) 000-0000]. In New York and Wisconsin, the Obligor is insured under an insurance policy issued by Blue Ridge Indemnity Company, [00000 Xxxxxxxx Xxxx Xxxx., Xxx. 000, Xxxxxxxxxxxx, XX 00000, Tel: (000) 000-0000]. IF THE OBLIGOR FAILS TO PROVIDE SERVICE OR PAY A CLAIM WITHIN SIXTY (60) DAYS AFTER YOU PROVIDE PROOF OF LOSS COVERED BY THIS AGREEMENT, OR IF THE OBLIGOR BECOMES INSOLVENT OR CEASES TO CONDUCT BUSINESS DURING THE TERM OF THIS AGREEMENT, YOU MAY SUBMIT YOUR CLAIM DIRECTLY TO THE APPLICABLE INSURER AT THE ABOVE ADDRESS FOR CONSIDERATION. DISPUTE RESOLUTION/ARBITRATION AGREEMENT AND CLASS ACTION WAIVER PLEASE READ THIS DISPUTE RESOLUTION/ARBITRATION AGREEMENT AND CLASS ACTION WAIVER, INCLUDING THE OPT- OUT PROVISION, CAREFULLY TO UNDERSTAND YOUR RIGHTS. IT REQUIRES THAT CLAIMS (AS DEFINED BELOW) BE RESOLVED SOLELY THROUGH BINDING ARBITRATION ON AN INDIVIDUAL BASIS, RATHER THAN BY A JURY OR IN A CLASS ACTION.
INSURANCE STATEMENT. OUR obligations under this AGREEMENT are insured under an insurance policy issued by Xxxxxx Southern Insurance Company 00000 Xxxxxxxx Xxxx Xxxx., Xxxx. 000, Xxx. 000, Xxxxxxxxxxxx, XX 00000, Tel: (000) 000-0000, except in California, Georgia, New York, Rhode Island and Wisconsin. In Georgia, OUR obligations under this AGREEMENT are insured under an insurance policy issued by the Insurance Company of the South, 00000 Xxxxxxxx Xxxx Xxxx., Xxxx. 000, Xxx. 000, Xxxxxxxxxxxx, XX 00000, Tel: (000) 000-0000. In California, New York, Rhode Island, and Wisconsin, OUR obligations under this AGREEMENT are insured under an insurance policy issued by Atlantic Specialty Insurance Company, 000 Xxxxx Xxxxxxx 000, Xxxxx 000, Xxxxxxxx, XX 00000, Tel: (000) 000-0000. In the event the OBLIGOR fails to pay an authorized claim within sixty (60) days after proof of loss has been filed, YOU may file a direct claim with Xxxxxx Xxxxxxxx Insurance Company, Insurance Company of the South, or Atlantic Specialty Insurance Company. To do so, please call the following toll-free number for instructions: (000) 000-0000. In the event of cancellation of OUR Contractual Liability Insurance Policy or Reimbursement Insurance Policy, coverage will continue for all contract holders whose service contracts were issued by US and reported to the insurer for coverage during the term of the reimbursement insurance policy.
INSURANCE STATEMENT. This is not an insurance policy. Our obligations under this Agreement are insured under an insurance policy issued by Xxxxxx Southern Insurance Company 00000 Xxxxxxxx Xxxx Xxxx., Xxxx. 000, Xxx. 000, Xxxxxxxxxxxx, XX 00000, Tel: (000) 000-0000, except in California, Georgia, New York, Rhode Island and Wisconsin. In California, if any promise made in the Agreement has been denied or has not been honored within sixty (60) days after Your request, You may contact the California Department of Insurance at (000) 000-0000 or access the department's Internet Web site (xxx.xxxxxxxxx.xx.xxx). In Georgia, Our obligations under this Agreement are insured under an insurance policy issued by the Insurance Company of the South, 00000 Xxxxxxxx Xxxx Xxxx., Xxxx. 000, Xxx. 000, Xxxxxxxxxxxx, XX 00000, Tel: (000) 000-0000. In Wisconsin, Our obligations under this Agreement are backed by the full faith and credit of Auto Knight Motor Club, Inc. 00000 Xxxxxxxx Xxxx Xxxx., Xxxx. 000, Xxx. 000, Xxxxxxxxxxxx, XX 00000, (000) 000-0000. In New York and Rhode Island, Our obligations under this Agreement are insured under an insurance policy issued by Atlantic Specialty Insurance Company, 000 Xxxxx Xxxxxxx 000, Xxxxx 000, Xxxxxxxx, XX 00000, Tel: (000) 000-0000. In the event the Obligor fails to pay an authorized claim within sixty (60) days after proof of loss has been filed, You may file a direct claim with Xxxxxx Southern Insurance Company, Insurance Company of the South, or Atlantic Specialty Insurance Company. To do so, please call the following toll-free number for instructions: (000) 000-0000.
INSURANCE STATEMENT. The Xxxxx Township School District has provided coverage for their student volunteers through the Volunteers of America. This insurance coverage will protect students while performing their internship roles. Part 4: Senior Experience Mentor Agreement Agency Information Business/Agency Name: Internship Address: Mentor: Title: Worksite Telephone: Fax: Mentor Email: ( ) No Email Name of Intern: Position: Mentor Responsibilities: The mentor will work to:
INSURANCE STATEMENT. OUR obligations under this AGREEMENT are insured under an insurance policy issued by Xxxxxx Southern Insurance Company 00000 Xxxxxxxx Xxxx Xxxx., Xxxx. 000, Xxx. 000, Xxxxxxxxxxxx, XX 00000, Tel: (000) 000-0000, except in New York, Rhode Island and Wisconsin. In New York, Rhode Island, and Wisconsin, OUR obligations under this AGREEMENT are insured under an insurance policy issued by Atlantic Specialty Insurance Company, 000 Xxxxx Xxxxxxx 000, Xxxxx 000, Xxxxxxxx, XX 00000, Tel: (000) 000-0000. In the event the OBLIGOR fails to pay an authorized claim within sixty (60) days after proof of loss has been filed, YOU may file a direct claim with Xxxxxx Southern Insurance Company, Insurance Company of the South, or Atlantic Specialty Insurance Company. To do so, please call the following toll-free number for instructions: (000) 000-0000. In the event of cancellation of OUR Contractual Liability Insurance Policy or Reimbursement Insurance Policy, coverage will continue for all contract holders whose service contracts were issued by US and reported to the insurer for coverage during the term of the reimbursement insurance policy.
