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HomeMy WebLinkAboutCORRESPONDENCE - GENERAL CORRESPONDENCE - INSURANCE CERTIFICATEACORD DATE (MM/DD/YYYY) TM. CERTIFICATE OF LIABILITY INSURANCE 03/12/2009 PRODUCER Phone: (360) 598-3700 Fax: (360) 598-3703 MICHAEL J. HALL 8r COMPANY THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE A/E INSURANCE SERVICES HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 19660 10TH AVENUE N.E. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. POULSBO WA 98370 INSURERS AFFORDING COVERAGE .1 ._Y,. NAIC# INSURED - - INSURER A: Lloyd's Of London GYROSCOPE INC INSURER B: Travelers Indemnity Co of Connecticut — - 283 FOURTH STREET, STE 201 OAKLAND,.CA 94607 INSURER C: Travelers Property Casualty Co of America — INSURER D: --- INSURER E: COVERAGES 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 LTR ADD-1-1 TYPE OF INSURANCE INSRD, POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS GENERAL LIABILITY 68068291_866 12/01/08 12/01/09 EACH OCCURRENCE $ 1,000, 000 � X COMMERCIAL GENERAL LIABILITY CLAIMS MADE F?-(] OCCUR DAMAGE TO RENTED PREMISES (Ea occurence) _ $ 300,000 MED. EXP (Any one person) Is, 5,000 PERSONAL & ADV INJURY $ 1,000,000 B —d GENERAL AGGREGATE $ 2,000,000 jGEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG. $ 2,000,000 I- .POLICY n PE� n LOG AUTOMOBILE LIABILITY ANY AUTO BA6831 L352 - 12/01/08 12/01/09 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 ALL OWNED AUTOS - - - - BODILY INJURY " SCHEDULED AUTOS - - (Per person) - $ --- B '•' '� ;HIRED,AUTOS .., , NON OWNED AUTOS �•---- _F• ! JI ;• �,: _ _ �' _ `. '"r r r ` BODILY INJURY P ,. (Pecaccldent)- - ERTY DAMAGE -- $ - - -- X, X- - - - Z -.; c•- m: - E LIABILITY .. - . .. AUTO ONLY - EA ACCIDENT $ AGARAGNY AUTO OTHER THAN EA,_ Cc AUTO ONLY: AGG $ EXCESS / UMBRELLA LIABILITY CUP7918YO69 12/01/08 12/01/09 EACH OCCURRENCE $ 3,000,000 X OCCUR CLAIMS MADE AGGREGATE Is 3,000,000 C I$ DEDUCTIBLE is RETENTION $ 0 .. Is WORKERS COMPENSATION AND EMPLOYERS' LIABILITY I WC STATU- TORY LIMITS OTHER ANY PROPRIETOR/PARTNER/EXECUTIVE ' E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ OTHER: PROFESSIONAL LIABILITY 1108621526/009 03/16/09 03/16/10 PER CLAIM A CLAIMS MADE FORM �$1,000,000 $2,000,000 AGGREGATE RETRODATE: 03-16-2001 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS City of Fort Collins is an additional insured per written contract or agreement between insured and insured's client on the Commercial General Liability Policy as respects liability arising out of activities by or on behalf of the named insured t91aml12w-'11a:[@]no SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City f FCollinsXPIRATION ty of DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS Director of Purchasing and Risk Management 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, P.O. BOX 580 ITS AGENTS OR REPRESENTATIVES. 215 North Mason Street, 2nd Floor AUTHORIZED REPRESENTATIVE] Fort Collins, CO 80522 Attention: James O'Neill Matthew L. COpUS ACORD 25, (2001/08) Certificate # 91678 © 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. AUUMU 2b-5 (2UU1/U8) Certificate #91678