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HomeMy WebLinkAboutClifford-Lee and Associates - Insurance Certificate A�® CERTIFICATE OF LIABILITY INSURANCE FDAT12/3/2024YY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT H &H Insurance Services, Inc. NAME: Marsha Mathews 3160 Campus Drive PHCNN Ex :678-252-1475 ac No: Suite 100 ADDRESS: Mmathews hhinsur.com Norcross GA 30071 INSURERS AFFORDING COVERAGE NAIC# INSURER A:Continental Western Insurance 10804 INSURED CLIFAND-01 INSURERB:Old Republic Insurance CO. 24147 Clifford-Lee and Associates P. O. Box 1175 INSURER C Pine Mountain GA 31822 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:466732100 REVISION NUMBER: THIS IS TO CERTIFY THAT 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 CERTIFICATE 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. INSR rypE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR POLICYNUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y CPA 4274094 5/1/2024 5/1/2025 EACH OCCURRENCE $1,000,000 CLAIMS-MADE I]OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $500,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY 1 PEOOT- LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY Y Y CPA 4274094 5/1/2024 5/1/2025 COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ X HIRED IX NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ A UMBRELLA LIAB X OCCUR Y Y CUA 4524423 5/1/2024 5/1/2025 EACH OCCURRENCE $5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED RETENTION$ $ —waRtcet-5COMPENSATION-- -1� MWC30233 /1%2 26 -- — AND EMPLOYERS'LIABILITY YIN N T STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 A Installation Floater Y Y CPA 4274094 5/1/2024 5/1/2025 Limit 100,000 A Leased/Rented Equipment Y Y CPA 4274094 5/1/2024 5/1/2025 Limit 120,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins 281 N College AUTHORIZED PRES TATIVE Fort Collins CO 80524 _©-198a_2015 er QRn CORD DRAZ40N^AU rightssaserued. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD