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HomeMy WebLinkAbout144217 CANNON COCHRAN MGMT SERVICES CCMSI - INSURANCE CERTIFICATE (4)Client#: 67967
CCMSHOI
ACORD,. CERTIFICATE OF LIABILITY INSURANCE
D8/03/2010Y)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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).
PRODUCER
Mackey Team
Mesirow Insurance Services, Inc.
353 N. Clark Street
CONTACT Leah Cozad
NAME:
PHONE 312 595-6200 FAX
AIC No Ext : AIC, No):
E.L
ADDRESS:
Chicago, IL 60654
CUSTOMER ID#:
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURED
A: Charter Oak Fire Insurance Comp
25615
CCMSINSURER
Holdings, Inc
INSURER B : Travelers Property Casualty Co.
25674
2 East Main Street, Suite 208
2 East
Towne Centre Building
Danville, IL 61832
INSURERC: Farmington Casualty Company
41483
Navigator Specialty Insurance
INSURER D : g P tY
36056
INSURER E : Lexington Insurance Company
19437
INSURER F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: I
THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
D L
NSR
(;UBR
WVD
POLICY NUMBER
POLICY EFF
MM/DDIYYYY
POLICY EXP
/Y MM/DDYYY
LIMITS
A
GENERAL LIABILITY
X
P6301918P719
11/17/2009
11/17/201C
EACHOCCURRENCE
$1,000,000
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE I OCCUR
DAMAGE TO RENTED
PREMISES Ea occurrence
$100,000
MED EXP (Any one person)
$5,000
PERSONAL & ADV INJURY
$1,000,000
GENERAL AGGREGATE
$2,000,000
GEML AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$2,000,000
POLICY PRO X LOC
$
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
P8101918P719 _
11/17/2009
11/17/201C
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
BODILY INJURY (Per person)
$
ALL OWNED AUTOS
BODILY INJURY (Per accident)
$
X
SCHEDULED AUTOS
HIRED AUTOS
PROPERTY DAMAGE
(Per accident)
$
X
NON -OWNED AUTOS
$
B
UMBRELLA LIAB
X
OCCUR
CUP1918P71909
11/17/2009
11/17/2010
EACH OCCURRENCE
$10,000,000
AGGREGATE
$10,000,000
EXCESS LIAB
CLAIMS -MADE
DEDUCTIBLE
S
$
X
RETENTION $ 10000
C
--
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVEY I N
OFFICER/MEMBER EXCLUDED? �
(Mandatory in NH)
N/A
PFUB1918P719
11/17/2009
11/17/2010
X I TO Y LIMIT OTH-
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE - EA EMPLOYEE
$1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below-
E.L. DISEASE -POLICY LIMIT
$1,000,000
D
Errors 8r
�006761856
NYIOMPL0007121C i07/31/2010
07/31/2011
$5MM Per Occ/$5MM Agg
E
Omissions
107/31/2010
07/31/2011
$5MM Excess
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
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.
l.tKI lrlt Alt KULILi GANGELLATION iu uays for Non-Navment
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS.
P.O. Box 580
Fort Collins, CO 80522-0000 AUTHORIZED REPRESENTATIVE
-Pr.
01988-2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S785045/M784977 LZC
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