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HomeMy WebLinkAboutTECH RESOURCES - INSURANCE CERTIFICATE'�4BD, CERTIFICATE OF LIABILITY INSURANCE
09/22/200 )
PRODUCER (330) 782-8068 FAX (330) 782-0458
Cailor Fleming & Assoc.
4610 Market St.
P.O. BOX 3989
Youngstown, OH 44513
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 Tech Resources, Inc.
1251 Dublin Rd.
Columbus, OH 43215
INSURERA: Citizens Insurance Company
INSURERB: DVUA West Virginia, Inc.
INSURER C:
INSURER D:
INSURER E:
COVFRG[AFS
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
4DD'L
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATION
LIMITS
GENERAL LIABILITY
ODW573644202
12/04/2003
12/04/2004
EACH OCCURRENCE
$ 1,000100
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
$ 300,000
CLAIMS MADE M OCCUR.
MED EXP (Any one person)
$ 15,000
A
PERSONAL &ADV INJURY
$
GENERAL AGGREGATE
$ 2,000,000
GEML AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$
POLICYF'j PROJECT LOC
AUTOMOBILE LIABILITY
ANY AUTO
ODWS73644202
12/04/2003
12/04/2004
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
BODILY INJURY
(Per person)
$
A
ALL OWNED AUTOS
SCHEDULEDAUTOS
X HIRED AUTOS
X NON -OWNED AUTOS
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
rl
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
V
Y
r(
- THAN EA ACC
�
$
$
.� � VVVV
NLY: AGG
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR O CLAIMS MADE
CC
OC
? 2004
AGGREGATE
$
$
DEDUCTIBLE
CITY OF
FC.ia:: I..OLL
NS
$
$
RETENTION $
RISKAXTAI-
WORKERS COMPENSATION AND
WC STATU- OTH-
Y LIMITSFIR
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
$
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED?
If yes, describe under
E.L. DISEASE - EA EMPLOYE
$
E.L. DISEASE - POLICY LIMIT
$
SPECIAL PROVISIONS below
B
roessional Liability
H704-10129
01/1S/2004
01/1S/200S
$1,000,000 w/$2,S00 Deductible
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
ITY OF FORT COLLINS IS NAMED AS ADDITIONAL INSURED
CITY OF FORT COLLINS
CITY'S DIRECTOR OF PURCHASING & RISK MANAGEME
P.O. BOX 580
FORT COLLINS, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
10 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 REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2001/08) ©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.
AI:VKU Zb (ZUU11UU)
Additional Coverages and Factors
Line of Business Coverages for General Liability
06/18/2004
Coverage Limits Ded/Ded Type Rate Premium Factor
General Aggregate 2,000,000
Each Occurrence 1,000,000
Fire Damage 300,000
Medical Expense 15,000