HomeMy WebLinkAbout309950 T2 SYSTEMS INC - INSURANCE CERTIFICATE (6)ACORD� CERTIFICATE OF LIABILITY INSURANCE
°"T01/09/04'
PRODUCER 317-615-7600
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Acordia
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
111 Monument Circle, Ste. 3200
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P. 0.. Box 44980
Indianapolis, IN 46244
INSURERS AFFORDING COVERAGE
INSURED T2 Systems
INSURER A: ITT Hartford Insurance Group
Mr. Troy Lane
INSURER B:
7835 Woodland Drive, #250
INSURER C:
Indianapolis IN 46278
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.
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE IMM/ODNYt
POLICY EXPIRATION-LIL
DATE (MMIDDNY)
LIMITS
A
GENERAL LIABILITY
36SBAAD3437
1 /01 /04
1 /01 /05
EACH OCCURRENCE
$ 1000000
FIRE DAMAGE (Any one tire)
$ 100000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 51OCCUR
IVIED EXP (Any one person)
S 10000
PERSONAL& ADV INJURY
$ 1000000
GENERAL AGGREGATE
$ 2000000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGO
$ 2000000
POLICY PRO JECT LOC
AUTOMOBILE
LIABILITY,
ANY AUTO -
-,
COMBINED SINGLE LIMIT
(Ea accident)
BODILY INJURY ---
(Per person)
S -
ALL OWNED AUTOS
SCHEDULED AUTOS
-
BODILY INJURY
(Per accident)
$
HIRED AUTOS -- -
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
S
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
S
OTHER THAN EA ACC
$
ANY AUTO
S
AUTO ONLY: AGG
EXCESS LIABILITY
EACH OCCURRENCE
$
AGGREGATE
9
OCCUR F-ICLAIMS MADE
S
$
DEDUCTIBLE
$
RETENTION $
A
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
36WECKE3694
1 /01 /04
1 /01 /05
T'C sT AT OTH-
ER
E.L. EACH ACCIDENT
S $00000
E.L. DISEASE - EA EMPLOYEE
$ 500000
E.L. DISEASE - POLICY LIMIT
S 500000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE: THE BELOW REFERENCED CERTIFICATE HOLDER IS ADDITIONAL INSURED
ATIMA.
CERTIFICATE HOLDER I I ADDITIONAL INSURED- INSIIRFR I I=FR CANCELLATION
City of Fort Collins, Colorado
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
Purchasing Division
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
215 North Mason St., 2nd Floor
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Fort Collins, CO 80524
REPRESE TIVES.
AUTOO ZE EP ESENTAT
ACORD 25-S (7/97) 60- 31 T2SJ8830-,83i1112 O ACORD CORPORATION 1988