HomeMy WebLinkAboutTodd HoudekPolicy Number
C H U B B o APR 2 2 2025 SVRD95428113
Renewal Of:
SVR D95428113
COMMON POLICY DECLARATIONS
ACE American Insurance Company
436 Walnut Street , Philadelphia, PA 191D6
Item 1. Named Insured and Mailing Address Agent Name and Address
DD L HOUDEK CRC INSURANCE SERVICESLL
5210 Cleveland Blvd, STE 140-357 THE ABC PROGRAM
CALDWELL ID 83607 ONE METROPLEX DR SUITE 400
BIRMINGHAM AL 35209
Agent No. Z09029
Item 2. Policy Period From: 03-27-2025 To: 03-7-2026
at 12:01 A.M., Standard Time at your maiing address shown above.
Item 3. Business Description:
Form of Business: INDIVIDUAL
Item 4. In return for the payment of the premium, and subject to all the terms of this policy, we agree with you to provide
the insurance as stated in this policy.
This policy consists of the following coverage parts for which a premium is indicated. Where no premium is shown, there
is no coverage. This premium may be subject to adjustment.
Coverage Parts) Premium
Commercial Property Coverage Part $
1,182.00
Commercial General Liability Coverage Part $
300.00
Crime and Fidelity Coverage Part
NOT COVERED
Commercial Inland Marine Coverage Part
NOT COVERED
Commercial Auto (Business or Truckers) Coverage Part
NOT COVERED
Commercial Garage Coverage Part
NOT COVERED
Total Policy Premium $
1,482.00
Item 5. Forms and Endorsements
Form(s) and Endorsement(s) made a part of this policy at time of issue; BILLTYPE: Agent
See Schedule of Forms and Endorsements BILL PLAN: Annual
Billing
Countersigned:
Date:
By:
Authorized Representative
THIS COMMON POLICY DECLARATION AND THE SUPPLEMENTAL DECLARATION(S), TOGETHER WITH THE COMMON POLICY CONDITIONS,
COVERAGE PART(S), COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS, IF ANY. COMPLETE THE ABOVE NUMBERED POLICY.
ALL-24624 (01108)
Insured Copy