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HomeMy WebLinkAboutJessen Communications, Inc. - Insurance Certificate 2025 i AC. ® DATE(MMIDO(YYYY) I �/ 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(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 hot confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME; Juanita Velasquez _ Holmes Murphy&Associates PHONE 214-265-6628 ac No 2727 Grand Prairie Parkway WC,N Waukee IA 50263 ADDRE velas uez holmesmu h .com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Travelers Indemnity Company 25658 INSURED JESCOMPC INSURER B:Travelers Property Casualty Co.America 25674 Jessen Communications, Inc. 2201 23rd Avenue INSURERC: Pinnacol Assurance Company 41190 Longmont, CO 80501 i_NSURERD_Admiral Insurance 24856 INSURER E:Travelers Indemnity Co of America _ 25666 INSURER F: COVERAGES CERTIFICATE NUMBER:1074746062 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 ADDLjSUBRI _ _ .-_ POLICY EFF POLICY EXP LTR TYPEOFINSURANCE N D.WVDI POLICYNUMBER MMIDD/YYYY MMIUD/YYY LIMITS E X COMMERCIAL GENERAL LIABILITY Y Y 4TCO2246R688TIA 6/1/2025 ! 6l1/2026 EACH OCCURRENCE $1,000.000 —' DAMAGE TO RENTED--- CLAIMS-MADE X OCCUR PREMISES-tEa cu ocrrence $300,000 _ X MED EXP(An one person) $5,000 _PC,Dad$5,000 y PERSONAL&ADV INJURY $1,000,000 ---------- GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY'� JE T LOG j PRODUCTS-COMP/OP AGG $2.000,000 OTHER: $ A AUTOMOBILE LIABILITY Y Y 810ON837220 6/1/2025 6/1/2026 COMBINED SINGLE LIMIT $1,000,000 _ I i (Ea accdent)----------�-----__ - X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ X X PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY LPer_accoi n� _._.. -- --- ----------- B X UMBRELLALIAB X OCCUR Y Y CUP5N371361 6/1/2025 6/1/2026 EACH OCCURRENCE_ $5.000,000 EXC S B CLAIMS-MADE I AGGREGATE^ $5,000,000 ' EXCESUA DEDX RETENTION$1 n nnn $ C WORKERS COMPENSATION Y 4069629 6/1/2025 6/1/2026 iX PER OT - AND EMPLOYERS'LIABILITY , STATUTE ER _ ANYPROPRIETOFVPARTNER!EXECUTIVE Y/N E L EACH ACCIDENT $1,000,000 OFFICER MEMBEREXCLUDEO? NIA ------------- —_ (Mandatory In NH) E.L.DISEASE-.EA EMPLOYEE $1,000,000 II yes,describe under ! - DESCRIPTION OF OPERATIONS below 1 E.L.DISEASE•POLICY LIMIT $1,000,000 D j Pollution Liability ------ FEIECC1916611 6l112025 6/1l2026 $110d Each/Aggregate $5,000 Deductible B LeasedlRentedEquipment QT660367M6221TIL25 6/1/2025 6/1/2026 a50000Urrut i S1,000Deductible i DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) RE:Right-of-Way Contractors License The Certificate Holder is an Additional Insured on General Liability as required by written contract with the insured,per 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; Engineering Department ACCORDANCE WITH THE POLICY PROVISIONS. 281 N. College Avenue.; PO Box 580 Fort Collins CO 80522-0580 AUTHORIZED REPRESENTATIVE USA �V ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 3887: 2 ' of 2