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Home My WebLink AboutR3 CONSULTING GROUP - INSURANCE CERTIFICATEA RD,N CERTIFICATE OF LIABILITY INSURANCE osii4/2 8 PRODUCER (916)488-4702 FAX (916)488-2336 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION BBA: MCCI atchy Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE License #0724020 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 2410 Fair Oaks Blvd, Suite 140 Sacramento, CA 95825 INSURERS AFFORDING COVERAGE NAIC # R3 Consulting Group, Inc. INSURER& Hartford Insurance Co. 4811 Chippendale Dr., #708 INSURERS: Philadelphia Insurance Sacramento, CA 9584I-2554 INSURER C: INSURER O: nnvcowrec 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. INSRT. 00 TYPE OF INSUR/1NCE POLICY NUMBER POLICY EFPECTIVE POLICY EXPIRDWI ATION LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FR7 OCCUR S7 SBA AT6312 SC 11/27/2007 11/27/2008,. EACHOCCURRENCE $ 2,900,000 DAMAGETORENTEOw $ 300,00 MEO UP (Any ono person) $ 10,000 PERSONAL 8 AOV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000, 000 GEMLAGGREGATE LIMIT APPLIES PER: X POLICr j5RCGy f7 LOG PRODUCTS• COMPIOP AGG S 4,000.000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULEOAUTOS HIRED AUTOS NON•OWNEO AUTOS 57 SBA AT631Z SC 11/27/2007 11/27/2008 COMBINED SINGLE LIMIT (Ea awidonp $ 21000,000 BODILY INJURY (Par parson) $ X BODILY INJURY (Par KgWent) $ X PROPERTY DAMAGE (Par sadden) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EAACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ S EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE I-OUCTIBLE RETENTION S EACH OCCURRENCE $ AGGREGATE S 6 $ S A WORKERS COMPENSATION AND EMPLOYERS'LIABIUYY OFFICEWMEMBER EXCLUDEoiEOUTIVE If Yee, aeeaAIa undo, SPECIAL PROVISIONS We. 57 WBC NP9192 02 07/01/2008 07/01/2009 OTH- 1 wC STATU.S PH _ E.L.EACHACCIDENT $ 1,000,000 E.L. DISEASE, EA EMPLOYEES 1,000,00 E, L. DISEASE -POLICY LIMIT $ 1,000,000 g ro essiona1 Liability PHSU218402 12/15/2007 12/15/2008 $Z,000,000 Annual Aggregate $2,000,000 Each Claim $5,000 Deductible DESCRIPTIONOFOPERATI=11.0C TIQNS/ VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS E: Title: HHW ___ ' ination Grant dditional Insureds: City of Fort Collins, the City, its officers, agents and employees Ten day notice of cancellation applies for non-payment of premium. City of Fart Collins ATTN: John Stephen P.O. Box 580 Fort Collins, CO BOS22 ACORD 25 (2001108) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING MEURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. (DACURD QQHU L)KAI IUN TBOO MIA dHOSVIO-ON 9ECZS860T6 XVd CO:60 8009/PT/90 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement($). 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 26 (2001108) coo (A IHDSB'[D-M MZ909T6 %Bd V0:60 900Z/VT/90 57 SBA AT6312 SC THIS L"^NDORSFMENT 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 ATTN: John Stephen P.O. Box 580 Fort Collins, CO 80522 Re: Project Title: HHW Coordination Grant (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 1185 Copyright, Hartford Fire Insurance Company too In AHDIVID-an 9CCZ MT6 XVd b0:60 600Z/VT/80