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HomeMy WebLinkAbout144217 CANNON COCHRAN MGMT SERVICES CCMSI - INSURANCE CERTIFICATE (7)ACORDM CERTIFICATE OF LIABILITY
INSURANCE
10/OS/20o '
PRODUCER (217)442-0640 FAX (217)442-0067
ONB Insurance Group, Inc.
923 North Vermilion
P. 0. Box 10
Danville, IL 61834-0010
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED Cannon Cochran Management Services, Inc.
2 East Main Street
Towne Centre Bldg., Suite 208
Danville, IL 61832-5850
INSURERA: HARTFORD INS CO
INSURERB: TRAVELERS
INSURERC:
INSURERD:
INSURER E:
CnVFRA[:FS
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIN
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.
INSR
IkDD'L
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MWDD(YYI
11/17/2004
POLICY EXPIRATION
DATE IMIWDDIM
11/17/2005
LIMITS
GENERAL LIABILITY
83UUNPL1931E
EACH OCCURRENCE
$ 1,000,00
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
$ 3,000,000
CLAIMS MADE O OCCUR
MED EXP (Any one person)
$ 5,000
A
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
S 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PROECT LOC
J
PRODUCTS - COMP/OP AGG
$ 1,000,000
AUTOMOBILE
LIABILITY
ANY AUTO
83UENPL1899E
11/17/2004
11/17/200S
COMBINED SINGLE LIMIT
(Ea accident)
$
1,000,00
X
BODILY INJURY
(Per person)
$
A
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
X
BODILY INJURY
(Per accident)
$
X
UM/UIM
X
PROPERTY DAMAGE
(Per accident)
$
lil
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
OTHER THAN EA ACC
$
$
AUTO ONLY: AGG
EXCESS/UMBRELLALIABILITY
83XHUDN2999E
11/17/2004
11/17/2005
EACH OCCURRENCE
$ 5,000,00
X OCCUR ❑ CLAIMS MADE
AGGREGATE
$ S,000,000
A
$
RXDEDUCTIBLE
$
RETENTION $ 10,00
$
WORKERS COMPENSATION AND
83WBGK9575
11/17/2004
11/17/2005
X WC STATU- OER
A
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. EACH ACCIDENT
$ 500,000
E.L. DISEASE - EA EMPLOYE4
$ SOU, OO
E.L. DISEASE - POLICY LIMIT
1 $ S00, 00
OTH�R
mp oyee Dishonesty
104337699
06/14/2004
06/14/2005
B
and
LIMIT 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS
ertificate Holder is named as Additional Insured under the Automobile Liability and General
Liability for work performed by the Insured, only
City of Fort Collins
Attn: Jim O'Neill II, CPPO, FNIGP
P 0 Box S80
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
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRE
AUTHORIZED REPRESENTATIVE
Myrna Poggendorf/MYRNA s"
ACORD 25 (2001108) ©ACORD CORPORATION 1988