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HomeMy WebLinkAbout144217 CANNON COCHRAN MGMT SERVICES CCMSI - INSURANCE CERTIFICATEAC(RDM CERTIFICATE OF LIABILITY
INSURANCE
DATE(MMIDD/YYYY)
10/05/2004
PRODUCER (217)442-0640 FAX (217)442-0067
ONB Insurance Group Inc
923 North Vermilion
P 0 Box 10
Danville IL 61834-0010
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 Cannon Cochran Management Services Inc
2 East Main Street
Towne Centre Bldg Suite 208
Danville IL 61832-5850
fNSURERA HARTFORD INS CO
INSURER TRAVELERS
INSURER
INSURER
INSURER E
C(
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
ADD
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATION
LIMITS
GENERAL LIABILITY
83UUNPL1931E
11/17/2004
11/17/2005
EACH OCCURRENCE
$ 1 000,00
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE M OCCUR
DAMAGE TO RENTED
$ 3,000 DD
MED EXP (Any one person)
$ 5 DD
A
PERSONAL & ADV INJURY
$ 1 000 00
GENERAL AGGREGATE
$ 1 000,000
GEN L AGGREGATE LIMIT APPLIES PER
POLICY PEO LOC
PRODUCTS COMP/OPAGG
$ 1 000,00
AUTOMOBILE
LIABILITY
ANV AUTO
83UENPL1899E
11/17/2004
11/17/2005
COMBINED SINGLE LIMIT
(Ea accident
$ 1 DDD DD
X
A
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON OWNED AUTOS
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
UM/UIM
X
PROPERTY DAMAGE
(Per accident
$
GARAGE LIABILITY
AUTOONLV EAACCIDENT
$
ANYAUTO
OTHER THAN EA ACC
AUTO ONLY AGG
$
$
EXCESS/UMBRELLA LIABILITY
X OCCUR CLAIMS MADE
83XHUDM2999E
11/17/2004
11/17/2005
EACH OCCURRENCE
$ 5 000,00
AGGREGATE
$ 5 000,000
A
$
DEDUCTIBLE
X RETENTION $ 10 00
$
WORKERS COMPENSATION AND
83WBGK9575
11/17/2004
11/17/2005
X I TW& STATU OTH
EMPLOYERS LIABILITY
E L EACH ACCIDENT
$ 500,00
A
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED'+
If yes describe under
SPECIAL PROVISIONS below
E L DISEASE EA EMPLOYE
$ 500 00
r
E L DISEASE POLICY LIMIT
$ Soo 00
B
LOTH Royee Dishonesty
mp
and
104337699
06/14/2004
06/14/2005
LIMIT 1 000 000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS
Certificate Holder is named as Additional Insured under the Automobile Liability and General
Liability for work performed by the Insured only
City of Fort Collins
Attn Jim O'Neill II, CPPO FNIGP
P 0 Box 580
Fort Collins, CO 80522-0580
SHOULD ANY OF
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
Myrna Poggendorf/MYRNA
AL:VKU ZO (ZUUT/UU) ©ACORD CORPORATION 1988