HomeMy WebLinkAboutAction Target Inc - Insurance Certificate 2025 AFRO® DATE(MMIDD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 5/28/2025
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(les)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
NAME IMA Certificate Team
IMA, Inc. -Salt Lake City PHONE — —--_— — FAx -
95 S State Street - A/c No):
Suite 1300 ADDRESS: ce6ficates@imacorp.com
Salt Lake City UT 84111 _ INSURER(S)AFFORDING COVERAGE NAIC#
License#:PC-1210733 INSURERA:Twin City Fire Insurance Company 29459
INSURED ACTITAR-01 INSURER B;Trumbull Insurance_Company 27120
Action Target Inc.
3411 South Mountain Vista Pkwy INSURERC: Hartford Fire Insurance Company 19682
34 —
Provo UT 84606 INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:1059519182 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.
INERT — - ADDL$UBR 00-0C EPP j POLIpY EXP 1 -- --
LTR TYPEOFINSURANCE 11N DIW� POLICY NUMBER MMIDDIYYYY 1 MMALDI YYY ! LIMITS
A X COMMERCIAL GENERAL LIABILITY Y Y 34CESOFOOSU 5/26/2025 6130/2026 EACH OCCURRENCE $1,000,000
CLAIMS-MADE X OCCUR DAMADORE D
PREMISES Ea occurrence $3 00,000
MED EXP(Any oneperson) $10,000
PERSONAL&ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
1
POLICY 1 JE 0 LOG PRODUCTS-COMPlOP AGG $2.000,000
OTHER: $
B AUTOMOBILE LIABILITY Y Y 34UENBM10BP 5/26/2025 6/30/2026 COMBINED SINGLE LIMIT $1.000,000
Ea acCldenl _
t_..-,_..__ )- ----
X ANY AUTO BODILY INJURY(Per person) $
OWNED SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
f
X HIRED X NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY _�Pera�cidentj�`_____`__________,___
$
j UMBRELLA LIAR OCCUR EACH OCCURRENCE $
EXCESS LIAR CLAIMS•MADE AGGREGATE $
DED i RETENTION$ $
C WORKERS COMPENSATION I Y 34WBAV6L3B 1/31/2025 1/31/2026 X TAT TE ERH
AND EMPLOYERS'LIABILITY Y I N
ANYPROPRIETORiPARTNER/EXECUTIVE N E.L.EACH ACCIDENT $1.000,000
OFFICERIMEMBEREXCLUDED? N/A ---
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
It as,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
B Automobile Physical Damage 34UENBMIOBP 5/26/2025 6/30/2026 Comp.Ded.$1,000 Coll.Ded.$1,000
e Hired Car Physical Damage 34UENBMIOBP 5/26/2025 6/30/2026 Comp.Ded.$2,000 Coll.Ded.$2,000
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DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required)
Certificate Holder and all other parties required by the contract are included as Additional Insured on the General Liability and Automobile Liability Policies,if
required by written contract or agreement,subject to the policy terms and conditions.
This Insurance is Primary&Non-Contributory on the General Liability and Automobile Liability Policies,if required by written contract or agreement,subject to
the policy terms and conditions.
A Waiver of Subrogation is provided in favor of Certificate Holder and all other parties required by the contract on the General Liability,Automobile Liability and
Workers Compensation Policies,if required by written contract or agreement,subject to the policy terms and conditions.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS,
PO Box 580
Fort Collins CO 80522 AUTHORIZED REPRESENTATIVE
USA
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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