HomeMy WebLinkAbout451613 EMPLOYERS EDGE LLC - INSURANCE CERTIFICATE (3)c�® CERTIFICATE OF LIABILITY INSURANCE oPID KS 706/18/10
TE(MM/DDIYYYY)
1E� EMPLO-2
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Madison Insurance Group HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
425 S Cherry St #420 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver CO 80246
Phone:303-322-0800 Fax:303-322-0874
INSURERS AFFORDING COVERAGE
NAIC#
INSURED
INSURER A: Sentinel Insurance Company, Lt
11000
INSURER B: Hartford Insurance Company
0006
SStteli1y9rs Edge, LLC
INSURERC: Philadelphia Insurance Cos
006
2755 SS Locust St I
INSURERD:
Denver CO 80222
INSURER E:
COVERAGES I
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEDiTO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT ORIOTHER 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
PO ICY NUMBER
POLI Y EFFECTIVE
DATE MM/DD/YYYY
POLICY EXPIRATI N
DATE MM/DD/YYYY
LIMITS
B
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE [j] OCCUR
I
34SBARV1642
06/01/10
06/01/11
EACH OCCURRENCE
$ 1,000,000
PREMISES (Ea occurence)
s300,000
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY PRO LOC
JECT
PRODUCTS - COMP/OP AGG
s2,000,000
B
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
34SBARVI642
06/01/10
06/01/11
COMBINED SINGLE LIMIT
(Ea accident)
$ 1 O O O 0 O O
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
EXCESS I UMBRELLA LIABILITY
OCCUR F-ICLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
$
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVF�—�
OFFICER/MEMBER EXCLUDED? l_�I
(Mandatory in NH)
If Yes, describe under
SPECIAL PROVISIONS below
-
TORY LIMITS ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT 1
$
C
OTHER
Professional Liab
PHSD420657
06/01/10
06/01/11
Clms Made 1000000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
%,etc I IrwAI t MUL.Ur-K (;ANGLLLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 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
City Of Ft. Collins Purchasing Division AU H RIZEDREPRESENTATIVE REPRESENTATIVES.
VES.
215 N Mason, 2Floor
80
Ft Collins CO 80522
r.wRU ca tzVVV1U1) U TVUB-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
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
This Certificate of Insurance 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.
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