Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutCORRESPONDENCE - RFP - CLAIMS ADMINISTRATOR SERVICES (2)Client#- 67967
CCMSHOt
ACORD. CERTIFICATE OF LIABILITY INSURANCE
11/14/ 09 '
PRODUCER
Mackey Team
.^Iiesirow Insurance Services, Inc.
i0 N. Clark Street
Chicago, IL G0654
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 9
INSURED
Cannon Cochran Management Services, Inc.
2 East Main Street, Suite 208
Towne Centre Building
Danville, IL 61832
INSURER A: Charter Oak Fire Insurance Comp
25615
INSURER e: Travelers Property Casualty Co.
25674
INSURERc: Farmington Casualty Company
41483
INSURERD: Indian Harbor Insurance Company
36940
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.
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
FOLIC CT1VE
bAT MMIDDIYY
POLICY EXPIRATION
DATE MM1b0
LIMITS
A
GENERALLIABILITY
P6301918P719
11117/09
11/17/10
EACH OCCURRENCE
S1.000.000
COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
ea„ a
s300 000
CLAIMS MADE a OCCUR
P
MED EXP (Ary one person)
$10000
PERSONAL & ADV INJURY
S j 00Q 000
GENERAL AGGREGATE
s2,000,000
GEWL AGGREGATE LIMIT APPLIES PER:
PRODUCTS -COMPICPAGG
S1 000000
POLICY PROT X LOC
A
AUTOMOBILE LIABILITY
X ANY AUTO
P810191BP719
11/17109
11117/10
COMBINED SINGLE OMIT
(Eaamidenl]
s1,000,000
BODILY INJURY
(PC Persan)
S
ALL OWNED AUTOS
SCHEDULED AUTOS
X HIREDAUTOS
X NCH-OW&DAUTOS
BODILY INJURY
(Per acciderd(
S
PROPERTY DAMAGE
(Per accident)
S
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
S
OTHER THAN EA ACC
S
ANY AUTO
S
AUTO ONLY: AGG
B
EXCESS)UMBRELLALIABILITY
CUP1918P71909
11/17109
11117110
CACHOCCURRE14CE
$10 000 000
X OCCUR CLA161S MADE
AGGREGATE
S1 0,000,000
S
S
DEDUCTIBLE
S
X RETENTION $10000
C
WORKERS COMPENSATION AND
FMPLOYERS' LIAIMUTY
ANY PROPRIETORIPARTNERIEXECUTIVE
PFUB191BP719
11117/09
11117110
X nC� TAB OTH-
FR
E.L. EACH ACCIDENT
Si 000,000
E.L. DISEASE -EA EMPLOYEE
S1,000,000
OFFiCERIMEMBER EXCLUDED?
11 yes, describe under
SPECIAL PROVISIONS aolow
E.L. DISEASE -POLICY LIMIT I
S1 000000
D
OTHER Errors &
MPP002378602
07/31/09
07/31110
$10MM Per Occ1S10MM Agg
Omissions
DESCRIPTION OF OPERATIONS I LOCATIONS / 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 as required by written contract.
City of Fort Collins
P.O. BOX 580
Fort Collins, CO 80522.0000
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 113 DAYS 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. ITS AGENTS OR
AUTHOR IZgD R/EjPRESENTA71VE
Q P
AcoRD 25 Iz001108i 1 of 2 #S657104IM657054 LZC 0 ACORD CORPORATION 1988