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NATIONAL MULTIPLE SCLEROSIS - INSURANCE CERTIFICATE
�►coi2o® :.CERTIFICATE OF LIABILITY INSURANCE DATE01/06/2010 Ol/06/2010 PRODUCER Risk Services Northeast, Inc. ATHIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY otl New York NY Office AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 199 Water Street CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE New York NY 10038-3551 USA COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # PHONE- 866 283-7122 FAx- 847 953-5390 INSUREDG,, i•„� LI L' INSURER A: Great Northern insurance Co. 20303 ,National Multiple Sclerosis SOCJ e y olorado;hater„r !INSURERB: Federal Insurance:an pY. 20281._Com , . 900 5.'Broadway, 2nd Floor INSURERC_ Employers InsuranceYCompany of wadsau 21458 d Denu,er CO 80209 USA JAN 15 2010 INSURERD: ACE Property & Casualty insurance ;Co: e n ,r � ` IN x . > -• � SURER E: •.. , , .,_ _ . _ . O: COVERAGES?�✓ ; SIR. applies per terms and conditions of the policy x= THE POLICIES OF IN SURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. LIMITS SHOWN ARE AS REQUESTED 'INSR LTR.INSRE ADD -I!.. TYPE OF INSURANCE 'POLICY NUMBER POLICY EFFECTIVE ATE MM/DD POLICY EXPIRATION DATE M/DD .. .. _. LIMITS e ENERALLtABILITY 35833349 12/31/2009 12/31/2010 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $1,000,000 CLAIMS MADE ® OCCUR -' PREMISES (Ea occurrence),.. Any one person) PERSONAL & ADV INJURY $1,000,000 . •' GENERAL AGGREGATE $ 2 , OOO , OOO GEN'L AGGREGATE LIMIT APPLIES PER: , PRODUCTS-COMP/OPAGG $1,000,000 0-PRODUCTS POLICY ,❑_ PRO- LOC X JECT ❑ A - AUTOMOBH.E LIABILITY 7353-02-37 12/31/2009 12/31/2010 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $1, 000 , 000 ALL OWNED AUTOS - -- - �- -- - BODILY INJURY - SCHEDULED AUTOS ... - _ - _ .. - .... .�. -- -- ( Per person). ..... ...._._. _.. .. ,: ... - HIRED AUTOS' BODILY INJURY ...... - _ .... NON OWNED AUTOS _ .. .. (Per accident) ,. ... . - - PROPERTY DAMAGE - (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGG D EXCESS/UMBRELLA LIABILITY M00539375 12/31/2009 12/31/2010 EACH OCCURRENCE '..00CUR �n CLAIMS MADE ..AGGREGATE $5,000,000 - - - DEDUCTIBLE CRETENTION $10, 000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR / PARTNER / EXECUTIVE WCCZ ., X MC STATU- T RY LIMITS OTH- ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH)' E.L. DISEASE -POLICY LAST $1,000,000 Ifyes, describe under SPECIAL PROVISIONS below - OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEMCLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS City of Fort Collins is added as an Additional insured excluding Workers' Compensation and Employer's Liabi policy as required by written contract but limited to the operations of the Insured under said contract and subject to the policy terms, conditions and exclusions. v rn n vrn n m 0 Ln n i %_Z1%rl<r 1%_A I; L' .nvL Llr K LA1NUELLA l IUN �0EO "' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION �Attn• Lance Murray DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL BOX 580 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Fort Co l ns CO 22 USA 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 (2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD