The URL can be used to link to this page

Home My WebLink AboutALLIANT HOLDINGS I, LLC - INSURANCE CERTIFICATEtmenzw suaz ALLIHUL ACORD,. CERTIFICATE OF LIABILITY INSURANCE 1DATE (MM/DDN 2118/2009 YYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Alliant Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE New York -Executive Risk HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 99 Park Ave, Suite 1910 New York, NY 10016 INSURERS AFFORDING COVERAGE NAIC # INSURED Alliant Holdings I, LLC INSURER A: Darwin Select Insurance Company 24319 INSURER B: 1301 Dove Street, Suite 200 INSURER C: Newport Beach, CA 92660 INSURER D: INSURER E: nnVFRAnFR 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 POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ CLAIMS MADE OCCUR PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POUCYF_j PRO LOC JECT AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND OR I IMIT OTH- S PP EMPLOYERS' LIABILITY 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 $ A OTHER Professional 03042663 12/15/10 $15,000,000 occurrence/ Liability :77 aggregate $1,000,000 retention -1 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS This is a Claims Made Policy. See Attached Named Insured List. (See Attached Descriptions) �.�n r �rr�h r � nvw�n l.A1V l.CLLA l IVIV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fort Collins, CO DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 'An DAYS WRITTEN 215 North Mason St., 2nd FL NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Fort Collins„ CO 80524 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED REPRESENTATIVE ACORD 25 (2001/08) 1 of 3 #S10333/M10263 AAJ 0 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. AUUKU LS-5 (ZUU1/US) 2 of 3 #S10333/M10263 DESCRIPTIONS (Continued from Page 1) THE NAMED INSURED INCLUDES THE FOLLOWING ADDITIONAL ENTITIES: Alliant Holdings I, LLC Alliant Holdings II, LLC Alliant Holdings I, Inc. Alliant Holdings II, Inc. ARG Holdings, Inc. Alliant Insurance Services, Inc. Alliant Specialty Insurance Services, Inc. FHI Benefit Plans, Inc. dba: FHI Insurance Services Affinity Insurance Services, LLC dba Tribal First Partners, G.A. Chapin Insurance Services Austin, Cooper & Price Insurance Agency, Inc. Kelter-Alliant Insurance Services, Inc. dba Proquest Insurance Agency Colonial Healthcare, Inc. Franey Muha Alliant Insurance Services, Inc. Strategic HR Services, Inc. Gaddy -Ward & Company Insurance Brokers Benefit Management, Inc. Benefit Partners, LLC Benefit Partners-Alliant, Inc. Alliant Services Houston, Inc. Alliant Insurance Services Houston, LLC Clarity Benefit Consulting, LLC ClearPoint LP Alliant ClearPoint GP, Inc. Moore McNeil LLC AM, 20.3 (ZUUI/Utf) 3 of 3 #510333/M10263 rile.,*�• zns� Al I IWIll AC®RD. CERTIFICATE OF L:IABII..ITY INSURANCE DATE 1/13/2010"""") PRODUCER ` L ' Alliant Insurance Services, Inc.;' " , i New York -Executive Risk I MAR 2 201 99 Park Ave, Suite 1910 0EJ�; 6 �� New York, NY 10016 ' 'l -- HIS 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. IN AFFORDING COVERAGE NAIC # INSURED ` :. I - Alliant Holdings 1, LC--I-r'-'—'— —� ---.— 1301 Dove Street, Suite 200 I FEB Z O O Newport Beach, CA 92666 _ J I ✓ INSURER A: Darwin Select Insurance Company 24319 -INSURER B: INSURER C: INSURER D: INSURER E: C (IVPRAf:FC ,. 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 NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM DDIYY POLICY EXPIRATION DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMMISE(E.AGE GO RENTED AGE COMMERCIAL GENERAL LIABILITY ! CLAIMS MADE "OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OPAGG $ I POLICY PRO- LOC JECT AUTOMOBILE LIABILITY ANY AUTO - . - - -- COMBINED SINGLE LIMIT (Ea accident) - - BODILY INJURY (Per.person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ - GARAGE LIABILITY - AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR F—ICLAIMS MADE - AGGREGATE $ $ S DEDUCTIBLE $ RETENTION - S . - - WORKERS COMPENSATION AND - WC STATU- OTH- TITILIMIT E.L. EACH ACCIDENT_ - $ EMPLOYERS' LIABILITY - ANY PROPRIETiaR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? I E.L. DISEASE - EA EMPLOYEE $ If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLlC'Y LIMIT $ A O'fAER Professional '03042663 12/15/09 112/15/10 $15,000,000 Each Claim Liability $15,000,000. Aggregate $1,000,000 retention DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS - This is a Claims Made Policy. See Attached Named Insured List. (See Attached n iptions) City of Fort Collins, CO 215 North Mason St., 2nd FL 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 'In_ 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 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001/08).1 of 3 #S11089/M10815 JRL o ACORD CORPORATION 1988