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Home My WebLink AboutMILLIMAN - INSURANCE CERTIFICATEClient*- R443 MILLIMAN ACORDTM CERTIFICATE OF LIABILITY INSURANCE °"YYY' 06/2510 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Parker Smith & Feek, Inc. Bellevue Office ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 2233 112th Avenue NE Bellevue, WA 98004 INSURERS AFFORDING COVERAGE NAIC # INSURED Milliman Inc. 1301 Fifth Ave., Suite 3800 Seattle, WA 98101-2605 INSURER A: Great Northern Insurance Co. INSURERB: Pacific Indemnity Co. INSURER C: INSURER D: INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS A GENERAL LIABILITY 35825959 06/30/07 06/30/08 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEDtence) $1,000,000 CLAIMS MADE FXI OCCUR MED EXP (Any one person) $10 000 PERSONAL & ADV INJURY $1 000,000 GENERAL AGGREGATE $Z OOO 00O GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $1000000 POLICY PRO- JECT X LOC A AUTOMOBILE LIABILITY ANY AUTO 73525432 06/30/07 06/30/08 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ rl GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE $ DEDUCTIBLE $ RETENTION $ B WORKERS COMPENSATION AND 71719457 06/30/07 06/30/08 X WC LIMIT- oTH- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/FXECUTIVE E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT 11.000.000 OTHER 35825959 06/30/07 06/30/08 $1,000,000 Ea. Accident A EMPLOYERS LIAB WA & OH STOP GAP $1,000,000 Ea. Employee $2,000,000 Policy Limit DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Exhibit of Insurance. CITY OF FORT COLLINS Attn: Jim Hume 256 West Mountain Avenue Fort Collins, CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL �_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AI.UICU ZO (ZUUI/Ots) 1 of 2 #M77419 ICD00 0 ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25-S (2001/08) 2 of 2 #M77419