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HomeMy WebLinkAboutR3 CONSULTING - INSURANCE CERTIFICATEA�QR?„ CERTIFICATE OF LIABILITY INSURANCE 03/24/2008 PRODUCER (916)488-4702 FAX (916)488-2336 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION DBA: McCI atchy Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR License #0724020 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 2410 Fair Oaks Blvd, Suite 140 Sacramento, CA 95825 INSURERS AFFORDING COVERAGE NAIC # INSURED R3 Consulting Group, Inc. INSURER A'. Hartford Insurance Co. 4811 Chippendale Dr., #708 INSURER : Philadelphia Insurance Co. 0128 Sacramento, CA 95841-2554 INSURER C: INSURER D'. INSURER E: UUVtKAUCS 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 DD' TYPE OF INSURANCE POLICY NUMBER POLICV EFFECTIVE POLICY EXPIRATION LIMITS LTR Nag GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY 57 SBA AT6312 SC 11/27/2007 11/27/2008 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PREMISES Ea c�,�, rence) $ 300 QQQ MED EXP (Any one person) $ 10,000 CLAIMS MADE t n l OCCUR PERSONAL & ADV INJURY $ 2,000,000 A _] GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGO $ 4,000,000 POLICY PRO LOC ECT AUTOMOBILE LIABILITY ANY AUTO 57 SBA AT6312 SC 11/27/2007 11/27/2008 COMBINED SINGLE LIMIT (Ea accident) $ 2,000,000 BODILY INJURY (Per person) $ A ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS BODILY INJURY (Per accident) $ X X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EAACC AUTO ONLY: AGG $ ANY AUTO $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND EMPLOVERS'LIABILIW 57 WBC NP9192 02 07/Ql/2007 Q7/01/2Q08 WRy1JUL- GTH- __. .TS2BY-LN7LLS. E.L. EACH ACCIDENT $ 1,000,000 A ANY PROPRIETORIPARTNERIEXECUI IVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE -EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,00 $2,000,000 Annual Aggregate $2,000,000 Each Claim $5,000 Deductible B If yes, describe under SPECIAL PROVISIONS below OTHER Professional Liability PHSD218402 12/15/2007 12/15/2008 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Additional Insured: City of Fort Collins, its officers, agents and employees E: Project Title: Trash Service Study Ten days notice of cancellation applies for non-payment of premium. City of Fort Collins ATTN: Ann Turnquist 215 North Mason Street, 2nd Floor Fort Collins, CO 80524 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 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ArnranoRlonndnnm FAX: (910331 ©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. ACORD 25 (2001108) 57 SBA AT6312 SC THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE NAME OF PERSON OR ORGANIZATION City of Fort Collins, its officers, agents and employees ATTN: Ann Turnquist 215 North Mason Street, 2°' floor Fort Collins, CO 80524 Re: Project — Trash Service Study (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement) Who is an insured (Section 11) is amended to include as an insured the person or organization shown in the Schedule as an insured but only with respect to liability arising out of your operations or premises owed by or rented to you. CG 20 26 11 85 Copyright, Hartford Fire Insurance Company