HomeMy WebLinkAboutAAF INTERNATIONAL - INSURANCE CERTIFICATE (2)ACORD,� CERTIFICATE OF LIABILITY INSURANCE DAT/20/0D/YYYY)
06/20/OS
PRODUCER 1-212-994-7100 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Arthur J. Gallagher & Co. of NY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Madison Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
I Floor
York, NY 10022
INSURERS AFFORDING COVERAGE NAIC #
INSURED AAF Internntional INSURERA: Travelers Ind Cc Of Amer 25666
INSURERS: Travelers Prop Cas Ins Cc 36161
10300 Ormsby Park Place
INSURERC: Federal Ins Cc 20281
Louisville, KY 40223 INSURER D:
INSURER E:
I.UVCKAUr*
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
ADDI
POLICY NUMBER
POLICYEFFECTIVE
DATE IMMIDDNYI
POLICY EXPIRATION
DATE (MMIDDNY)
LIMITS
C
GENERAL LIABILITY
35379746
06/30/05
06/30/06
EACHOCCURRENCE
$1,000,000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE rx-1 OCCUR
DAMAGETORENTED
PREMISES (Ea ccurence)
MED EXP(Any one parson)
$ 1, 000, 000
$
PERSONAL SADV INJURY
$ 1,000,000
GENERALAGGREGATE
$ 10, 000, 000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMP/OP AGG
$2,000,000
X I POLICY r7 PRO- LOC
C
C
AUTOMOBILE
X
LIABILITY
ANY AUTO
73261760 (VA)
73225752 (A/O/S)
06/30/05
06/30/05
06/30/06
06/30/06
COMBINED SINGLE LIMIT
(Ea accident)
$ 2, 000, 000
C
ALLOWNEDAUTOS
SCHEDULEDAUTOS
73261761 (TX)
06/30/05
06/30/06
BODILY INJURY
(Perporson)
$
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTYDAMAGE
(Peraccident)
$
GARAGE LIABILITY
AUTO ONLY -EA ACCIDENT
$
OTHERTHAN EAACC
$
ANYAUTO
$
AUTOONLY: AGG
EXCESSIUMBRELLA LIABILITY
EACHOCCURRENCE
$
AGGREGATE
$
OCCUR CLAIMS MADE
$
DEDUCTIBLE
$
RETENTION $
A
B
WORKERS COMPENSATION AND
EMPLOYERS'LIAB
PART
ANY PROPRIETOR/PARTNER/E%ECUTIVE INC
OFFICEPJMEMBER EXCLUDED? EXCL
Kra , describe under
SCIAL PROVISIONS below
TC2HUB189K541805
TRJOY823KI42605
06/30/05
06/30/05
06/30/06
06/30/06
- OTH-
X WCSTATLIM T
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE - EA EMPLOYEE
$500,000
E.L. DISEASE - POLICY LIMIT
$500,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
City of Fort Collins is an Additional Insured as respects the General Liability Coverage for the work and/or services
provided or performed by the Named Insured if required by written contract.
City of Fort Collins, Purchasing Division
256 West Mountain
P.O. Box 580
Fort Collins, CO 80522-0580
USA
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 DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
AUTHORIZED REPRESENTATIVE
ACORD 25 (2001/08) emibli
Powered ByCertificatesNowm
1QAA
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.