I DATE (MM/DDIYYYY)
ACORD ®
INSURANCE BINDER 12/03/2021 THISBINDER IS A TEMPORARY INSURANCE CONTRACT, SUBJECT TO THE CONDITIONS SHOWN ON PAGE 2 OF THIS FORM. AGENCY R.D. Wood Insurance Associates, Inc. 5 515 Riverdale Rd Ste. E College Park, GA 30349 rtg N �o Extl:(770)991-6787 I rt� No):(67 8)545-3722 CODE: I SUB CODE: � COMPANY Northland Insurance Companies DATE EFFECTIVE 12/03/2021 I TIME 12:46 � AM X PM I BINDER# CP587975 EXPIRATION DATE TIME 01/02/2022 � 12:01AM NOON � THIS BINDER IS ISSUED TO EXTEND COVERAGE IN THE ABOVE NAMED COMPANY PER EXPIRING POLICY#: CP587 975 DESCRIPTION OF OPERATIONS/ VEHICLES/ PROPERTY (Including Location)
�8��g�ER 10:00009986 INSURED AND MAILING ADDRESS
Summerhill Neighborhood Development Geoffrey Heard 211 Georgia Avenue SE 1Atlanta, GA 30312
LIMITS
COVERAGES
TYPE OF INSURANCE CAUSES OF LOSS □
DEDUCTIBLE I COINS %
AMOUNT
COVERAGE/FORMS
1000.00 1 so I EACH OCCURRENCE Rg�ftiJ�EMISES
200.000.00
Commercial Property
PROPERTY ,_X BASIC
BROAD □ SPEC
S 1,000, 000 S 10Q,0QQ.QQ MED EXP(Anyoneperson) S EXCLUDED PERSONAL&ADV INJURY S 1,Q0Q,Q00 GENERAL AGGREGATE S 2,QQQ,Q0Q PRODucTs-coMPtOP AGG s Included COMBINED SINGLE LIMIT s
GENERAL LIABILITY LX COMMERCIAL GENERAL LIABILITY .-- � CLAIMS MADE [xJ OCCUR f-- ----------- VEHICLE LIABILITY - _ ANY AUTO OWNED AUTOS ONLY f-- _ SCHEDULED AUTOS HIRED AUTOS ONLY NON-OWNED AUTOS ONLY - ----------- VEHICLE PHYSICAL DAMAGE ---, ___j COLLISION: I OTHER THAN COL: GARAGE LIABILITY 7 ANY AUTO ---j DED �--------- 1 EXCESS LIABILITY 7 UMBRELLA FORM 7 OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND EMPLOYER'S LIABILITY f--
RETRO DATE FOR CLAIMS MADE:
BODILY INJURY (Per person) s BODILY INJURY (Per accident) s PROPERTY DAMAGE s MEDICAL PAYMENTS s PERSONAL INJURY PROT s UNINSURED MOTORIST s r�:•;z1 �CD /.'QTr·"iST 1P�'. ac(.,(!C"I!) s I ACTUAL CASH VALUE I , STATEDAMOUNT I I AUTO ONLY - EA ACCIDENT $ I OTHER THAN AUTO ONLY: I EACH ACCIDENT Is AGGREGATE s EACH OCCURRENCE s AGGREGATE s SELF-INSURED RETENTION s I PER STATUTE E.L. EACH ACCIDENT s 1 s
_I ALL VEHICLES
i_l SCHEDULED VEHICLES
RETRO DATE FOR CLAIMS MADE:
E.L. DISEASE - EA EMPLOYEE s E.L. DISEASE - POLICY LIMIT s FEES TAXES ESTIMATED TOTAL PREMIUM S ADDITIONAL INSURED LJ LOSS PAYEE LJ MORTGAGEE LENDER'S LOSS PAYABLE i i LOAN#:
SPECIAL CONDITIONS/ OTHER COVERAGES NAME & ADDRESS
TION. All rights reserved.
ACORD 75 (2016/03)
The ACORD name and logo are registere � arks of ACORD '\
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