SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE
DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
CANCELLATION
ACORD 28 (2016/03)
© 2003-2015 ACORD CORPORATION. All rights reserved.
NOYES
NOYES
If YES, LIMIT: DED:Subject to Different Provisions:
Subject to Different Provisions:
NAMED STORM INCL
DED:If YES, LIMIT:
If YES, LIMIT:
If YES, LIMIT:
If YES, LIMIT:
If YES, LIMIT:
If YES, LIMIT:
If YES, LIMIT:
RENTAL VALUE
N/A
FUNGUS EXCLUSION (If "YES", specify organization's form used)
LIMITED FUNGUS COVERAGE
$
EARTH MOVEMENT (If Applicable)
WIND / HAIL INCL
ORDINANCE OR LAW
EQUIPMENT BREAKDOWN (If Applicable)
COINSURANCE
AGREED VALUE
REPLACEMENT COST
DED:
IS DOMESTIC TERRORISM EXCLUDED?
IS THERE A TERRORISM-SPECIFIC EXCLUSION?
Attach Disclosure Notice / DECTERRORISM COVERAGE
BLANKET COVERAGE
YES NO
COVERAGE INFORMATION
FLOOD (If Applicable)
PERMISSION TO WAIVE SUBROGATION IN FAVOR OF MORTGAGE
HOLDER PRIOR TO LOSS
If YES, %
DED:
COMMERCIAL PROPERTY COVERAGE AMOUNT OF INSURANCE: DED:
PERILS INSURED BASIC BROAD SPECIAL
- Demolition Costs
- Incr. Cost of Construction
- Coverage for loss to undamaged portion of bldg
DED:
DED:
DED:
DED:
DED:
If YES, indicate value(s) reported on property identified above: $
BUSINESS INCOME If YES, LIMIT: Actual Loss Sustained; # of months:
If YES, LIMIT:
AUTHORIZED REPRESENTATIVE
ADDITIONAL INTEREST
NAME AND ADDRESS
LENDER SERVICING AGENT NAME AND ADDRESS
CONTRACT OF SALE
MORTGAGEE
LENDER'S LOSS PAYABLE
LOCATION / DESCRIPTION
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 EVIDENCE OF PROPERTY INSURANCE 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.
(ACORD 101 may be attached if more space is required)
BUILDING OR BUSINESS PERSONAL PROPERTY
THIS EVIDENCE OF COMMERCIAL PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS
UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER
THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN
THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST.
ADDITIONAL NAMED INSURED(S)
NAMED INSURED AND ADDRESS
CODE:
AGENCY
CUSTOMER ID #:
SUB CODE:
E-MAIL
ADDRESS:
(A/C, No, Ext):
PHONE
FAX
(A/C, No):
PRODUCER NAME,
CONTACT PERSON AND ADDRESS
EXPIRATION DATEEFFECTIVE DATE
THIS REPLACES PRIOR EVIDENCE DATED:
TERMINATED IF CHECKED
CONTINUED UNTIL
IF MULTIPLE COMPANIES, COMPLETE SEPARATE FORM FOR EACH
COMPANY NAME AND ADDRESS
NAIC NO:
POLICY TYPE
LOAN NUMBER
EVIDENCE OF COMMERCIAL PROPERTY INSURANCE
DATE (MM/DD/YYYY)
The ACORD name and logo are registered marks of ACORD
PROPERTY INFORMATION
LOSS PAYEE
7/7/2020
225-292-3515
37885
Arthur J. Gallagher Risk Management Services, Inc.
235 Highlandia Drive, Suite 200
Baton Rouge, LA 70810
XL Specialty Insurance Company
Seaview House
70 Seaview Avenue
Stamford CT
225-292-3893
Fine Arts
Board of Supervisors of Louisiana State University
and Agricultural & Mechanical College
253 LSU Alumni Center
Baton Rouge, LA 70803
06/01/2020
06/01/2021
Fine Arts Coverage - See Remarks for specifics
X
"All Risks"
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Proof of Insurance
POLICY NUMBER
UM00063945SP20A
ACORD 101 (2008/01)
The ACORD name and logo are registered marks of ACORD
© 2008 ACORD CORPORATION. All rights reserved.
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: FORM TITLE:
ADDITIONAL REMARKS
ADDITIONAL REMARKS SCHEDULE
Page of
AGENCY CUSTOMER ID:
LOC #:
AGENCY
CARRIER NAIC CODE
POLICY NUMBER
NAMED INSURED
EFFECTIVE DATE:
1
1
Arthur J. Gallagher Risk Management Services, Inc.
Board of Supervisors of Louisiana State University
and Agricultural & Mechanical College
253 LSU Alumni Center
Baton Rouge, LA 70803
28
EVIDENCE OF COMMERCIAL PROPERTY INSURANCE
REMARKS:
FINE ARTS INSURANCE:
$85,000,000 Blanket for the permanent collection and temporary loans coverage over the various collections at premises situated at the Louisiana State
University
$10,000,000 at any Un-Named Locations
$10,000,000 while in transit including personally conveyed
VALUATION:
Permanent Collection: Inventory amount or
market value, whichever the highest
Loans/Gifts: Amount outlined on the loan agreement/legal liability
Student Art: $500, proven sales price or cost to refabricate, whichever the highest
DEDUCTIBLES:
Permanent Collection: $2,500
Loans/Consignments: $0
Wind/Flood/Hail: $25,000
SPECIAL FINE ARTS POLICY FEATURES:
Partial Loss Agreement/Pair and Set Clause
Buy Back Agreement/Appraisal
Automatic Coverage - Newly Acquired: $500,000 U.S. Indemnity
Territorial Limits: Worldwide
FLOOD SUBLIMIT AND LIMITATION
$250,000 in the Aggregate with respect to loss of Flood or Surface Water in a basement in buildings not in an A Flood Zone.
All Flood Claims are subject to a $25,000 Deductible.