HomeMy WebLinkAboutFARNSWORTH GROUP INC - INSURANCE CERTIFICATE 2020-2021A`oRo' CERTIFICATE �F LIABILITY INSURANCE �ATE(MMl��lYYYYj
_ _ _ 3131l2020
� THIS CERTIFICATE IS ISSUED A5 A MATTER dF INFORMATION ONLY AND CONFERS NO RIGHTS UPON Ti1E CERTIFICATE HpLDER. THIS
CERTIFICATE pOES NOT AFFIRMA7IVELY OR I�EGATIVELY AMEND, EXTEND OR ALT�R THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER[S}, AUTHORIZED
REPR�SENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPOR7ANT: If the certifEcate holder is an AUDITIONAL INSUREp, the policy(fes) must have ADDITIONAL 1NSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the te�ms and condltions of the policy, certain policles may require an endorsemenk. A statement on
this certificate does not confer rights to the certificate holder ln Ifeu of such endorsement s).
PRODUCER CONTACT
NAME:
Cottingham & Butler PHONE Fnx
Robert Heath • 563-587-5004 nr� No : 563-583-7339
800 Mai� St. aaoR�ess:
Dubuque IA 52001 INSURER{g� AFFORDING COYERAGE NAIC tl
INSURED
Farnsworth Group, lnc.
2709 McGraw Dri�e
Bloomington IL fi1704
Hartford Fire Insurance
iNsuReRc: Twin City Fire Insurance Co.
iNsuReR o: Great Narthern Ins�rance Cc
FARNGRO-0f
24303
:OVERAGES CEi2TIFICATE NUMBER:919775328 REVISION NUMBER:
TFiIS IS TO CERTIFY iHAT THE POLICIES OF INSURANCE LISTED BELOW HAVE 6EEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOfl
INDICATED. NOTWIT1iSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRAGT OR OTHER DOCUMENT WIiH RFSPECT TO WHiCH THiS
CERTIFICATE MAY BE ISSUEO OR MAY PERTAIN, THE INSURANCE AFFORDED BY 7W@ POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL 7HE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PA1d CLAIMS.
ISR TypE OF INSURAIJCE AD4L SUBR pOLICY NUMBER MM! DYlYYYY MMID�lYYYY LIMITS
7R
A X COMMERCIAL GENERAL LIABILITY 83 UEN OB 8121 4I112D24 4I112021 EqCii OCCURRENCE S 1,Q00,000
CLAIMS-MA6E � OCCUR PREMISES Ea occurtenca 3 300,006
MED EXP (My one person} S 1
PERSONAL B ADV INJURY S 4
GEN'L AGGREGRTE LIMIT APPLIES PER:
POUCY � PR�� � LOG
JECT
OTHER:
A AUTOMpBILEL1ABiLITY
X ANY AUTO
4WN�D SCHE�ULED
AUTOS ONLY AU70S
HIRED NON•OWNEO
AUTOS ONLY AUTOS ON�Y
B X UMBRELLA LIAB X
EXGESS LIAB
DE� RETENTION
� WORKERSCOMPENSATION
AN� EMPLOYERS' LIABILITY
AIVYPROPRI �TORlPAR T N E RlEX
OFFICERIMEMBEREXGLUPED?
(Mandatory in NHj
4! yes, describe under
�ESCR�NTiON OF OPEiiATiON
0 Property
A Inland Marine
OCCUR
CLAIMS-MAOE
YfN
❑ NfA
4I1I2020 I 4/1/2021
PRdDUCTS - COMPlQP AGG 3 2,OQO,ODO
a
COM6INED SINGLE I.IAAIT S 1,000,004
Ea accidenl
BODILY INJURY (Par personj S
6001LY WdURY (Per accidentf S
PROPERTYPAMAGE f
Per accident
3
411/2020 4I1l2U21 Ep,CH OCCURRENCH E 8,aao.00a
AGGREGATE E
S
41tl2020 � 41112021
4I1l2020 411l2021
4IV2020 41ll2021
E.L. EACH ACCI�ENT 3 i,000,000
E.L. DISEASE - EA EMPL4YE E 1,000,000
E.L. DISEASE - pDLICY LIMIT a i.oao,000
Blankel euildinglBPP 520652000
Valuable Papars $84172i
INLMRenIeNLeasad a�00,000
83U EN088122
ZUP-81M716i7
83 WE OBSGOH
3605-04-86
83 MS ZVD526
OESCRIPTION OF OPERATIONS! LOCATIONS 1 YEHICL63 (ACORD 101, Additional Remerks Schadule, may 6e attaehed il more space Is requlrod)
F7C
Farnsworth Group, Inc. Project Manager Eric Clu�er
The Cily of Fort Collins, its officers, agents, and employees are additional insured on lhe General Liability and Auto Liability policies per written contract
between lhe named insured and the ceriificate holder thak requires such a status subject to the terms and conditions of lhe endorsemenl attached to the policy
A 30-day notice of canceliation is provided by the insurance company to lhe certificate holder as outlined by the endorsement atlached to the General Liability
policy.
TION
7he City of Forl Coklins
P,O. 8ox 580
215 N Mason
Fart Collins CO 80522
SHOUL� ANY OF THE ABOYE DESCRIBE� POLICIES BE CANCEl.LE� BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCOR�ANCE WITH THE PQLICY PROVISIONS.
REPRESENTATIVE
of America I 25674
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ACORb 25 (2016103j The ACORD name and loga are registered marks of ACORD