HomeMy WebLinkAbout392283 THE MILLER GROUP - INSURANCE CERTIFICATEJul-20-06 02:10pm From-Brown&Brown
9704844165 T-743 P.002/002 F-308
9C_4_RD CERTIFICATE 4F LIABILITY INSURANCE D07 o 06
MIOFI 3III 2MW
PRODUCER
Brown & Brown Inc
125 S Howes, Sth Floor
P 0 Sox 2226
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.
Fort Collins CO 80522-2226
Phone:970-482-7747 Fa(x:970-484-4165
INSURERS AFFORDING COVERAGE
NAIC#
INSURED
INSURERA: Landmark American Ins Co
INSURER &
The Miller Group Worldwide LLC
Attn. Doha milor
303 West Prospea8
Fort Collins CO0526
INSURERC:
INSURERD:
INSURERE:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE Pauay PERIOD INDICATED. NOTwrrHSTANDDIa
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOOUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICJES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAM,
LTRINSRE
TYPE OF INSURANCE
POLICY NUMBER
DATE MID
4A MMIO
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
a
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE M OCCUR
PREMISES Pa o¢ui:x
a
MED EXP (My on pmsm)
S
PERSONALSADVINJURY
IS
GENERAL AGGREGATE
a
GENL AGGREGATE WT APPLIES PER:
PoucY Lac
PRODUCTS - COUROP AGO
a
AUTOMODLE
LIABILITY
ANYAUTO
(ES w4d rvQ SINGLE LIMIT
S
ALL OWNED AUTOS
SCHEDULEDAUTOS
BOOLY INJURY
(Pv persm)
a
HakED AUTOS
NON -OWNED AUTO$
(Per
a
PROPERTY DAMAGE
(Prr gIxWCnI)
a
GARAGE LIAHLIY
AUTO ONLY - EA ACGOENT
a
ANY AUTO
GTHMTHAN EAACC
AUTO ONLY: AGG
a
a
EX011WUMBRELLA LIABILRY
OCCUR CLAIMS MADE
EACH OCCURRENCE
a
AGGREGATE
a
a
DMUCTIDLE
a
RETENTION $
$
WORKERS COMPENSATION AND
EMPLOYERS' LNB[7TY
TORwu LIMITS
EL EACH ACCIDENT
$
ANYPROPRIETORJPARTNERIEXECUTIVE
OFFICERlA,£M13ER EXGWOED7
Iye8� tlflefJI�1A1tlN
EL DISEASE -EA EMPLOYEE
S
E.L DISEASE -POLICY LIMIT$
SPECAL PROVISIONS below
OTHER
A Professional LER710302 07/10/06 07/10/07 Each CL $1,0001000
Liability DEDa $2,500 SA CL Agg $1,000,000
DESCRIPTION OF OPERATIONS f LOCATIONS f VEHICLES / EXCLUSIONS AOOFJ) BY ENDORSEMENT 1 SPECIAL PROVISIONS
Consulting Operations.
City Of Fort Collins
Purchasing Department
Attar: James R. O'Neil 11
P.O. Box 580
Fort Collins CO 80522
FORTCOL I SHOULD ANY OF TEE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRAT101
DATETHEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAY¢W1d TEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Jul 21 06 11:46a
CERTIFICATE OF INSURANCE
This certifies that ® STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois
❑ STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois
❑ STATE FARM FIRE AND CASUALTY COMPANY, Scarborough, Ontario
❑ STATE FARM FLORIDA INSURANCE COMPANY, Winter Haven. Florida
❑ STATE FARM LLOYDS, Dallas, Texas
insures the following policyholder for the Coverages indicated below:
Name of policyholder
Address of policyholder
Location of operations
Description of operations
THE MILLER GROUP WORLDWIDE LLC
303 W PROSPECT RD FORT COLLINS, CO 80526
P.1
The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is
�..a 1- a -11 ,tie #-...._ e....L,.;n �. A ^nnA inne of thnee nniirieS The limits of I',abilitV shown may have been reduced by any paid claims.
POLICY PERIOD
LIMITS OF LIABILITY
POLICY NUMBER
TYPE OF INSURANCE
Effective Data ;Expiration Date
(at beginning of policy period)
96-GR-3840-0
Comprehensive
Business Liability 09/10/2005 09/10/2006
------------------
BODILY INJURY AND
PROPERTY DAMAGE
- _ - — -
liusinsurance includes:
®Products - Completed Operations
® Contractual Liability
❑ Underground Hazard Coverage
Each Occurrence $ 1,000,000
® Personal Injury
❑ Advertising Injury
General Aggregate $ 2, 000, 000
❑ Explosion Hazard Coverage
❑ Collapse Hazard Coverage
Products - Completed $
❑
Operations Aggregate
POLICY PERIOD
BODILY INJURY AND PROPERTY DAMAGE
EXCESS LIABILITY
Effective Date Expiration Date
(Combined Single Limit)
❑ Umbrella
❑ Other
Each Occurrence $
Aggregate $
Part t STATUTORY
Part 2 BODILY INJURY
Workers' Compensation
and Employers Liability
Each Accident $
Disease Each Employee $
Disease - Policy Limit $
POLICY PERIOD
LIMITS OF LIABILITY
POLICY NUMBER
TYPE OF INSURANCE
Effective Date j pate
(at beginning of policy period)
THE CERTIFICATE OF INSURANCE IS NOT A GUN FKAt: r uF it suKAnta Anu rrrr r ncrc H rinnv , v yr u....+.".w.+„ V
AMENDS, EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN.
If any of the described policies are canceled before
its expiration date, State Farm will try to mail a written
notice to the certificate holder 30 days before
Name and Address of Certificate Holder cancellation. If however, we fail to mail such notice,
no obligation or liability will be imposed on State
CITY OF FORT COLLINS, a of its en s or re SeMatrves.
PURCHASING / C �—
PO BOX 580 G..J N+.>t
FORT COLLINS, CO 80522 SignawreofAuthortzedRepresentative
AGENT / b,(Lo
Title
2Z: Agent's
Quality Savice and P7S!nAFO Code6684Ma3 04-IM Printed in U.SA Brat) Bischoff AgenNorthern Colorado
07/21/2006 13:33 9703955660
PAGE 01/01
7G Policy No, 96-GR-3940-0 RFC' DATE JUL 21 2006 150e-F625
SECTION If ADDITIONAL INSURED ENDORSEMENT
Policy No.: 96-OR-3840-0
Named Insured: THE MILLER GROUP
WORLDWIDE LLC
Additional Insured (include address):
CITY OF FORT COLLINS
PURCHASING
Po Box 580
FORK' COLLINS CO 80521
FF-MOV
A
WHO IS AN INSURED, under SECTION II DESIGNATION OF INSURED, is amended to Include as an Insured the
Additional Insured shown above, but only to the extent that liability to imposed on that Additional Insured solely
because of your work performed for that Additional Insured shown above.
Any insurance provided to the Additional Insured shall only apply with respect to a claim made or a suit brought for
damages for which you are provided coverage.
The Primary Insurance coverage below applies only when there is an "X" in the box.
❑ Primary Insurance. The insurance provided to the Additional Insured shown above Shall be primary
insurance. Any insurance carried by the Additional Insured shall De noncontrioutory with respect to
coverage provided to you.
All other policy provisions apply.
FF-5"
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