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HomeMy WebLinkAboutNATIONAL MULTIPLE SCLEROSIS SOCIETY - INSURANCE CERTIFICATEA O® CERTIFICATE OF LIABILITY INSURANCE DATE(MO D0DNYYY) 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 Aon Risk Services Northeast, Inc. New York NY Office CONTACT NAME: PHONE (866) 283-7122 FAX (847) 953-5390 (A/C. No. Ext): A/C. No.): E-MAIL 199 Water Street New York NY 10038-3551 USA _ADDRESS PRODUCER 570000021731 CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE - - NAIC # INSURED INSURER A: Great Northern Insurance Co. 20303 National Multiple Sclerosis Society Colorado Chapter 900 S. Broadway, 2nd Floor INSURERB: ACE Property & Casualty Insurance Co. 20699 INSURERC: Employers insurance Company of Wausau 21458 Denver CO 80209 USA INSURERD: Federal Insurance Company 20281 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 5/UU412V112:i KLV151UN NUMKEK: 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. Limits shown are as requests INSR LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER JMM1DD MMIDD LIMITS D GENERAL LIABILITY 17fEACH OCCURRENCE $1, 000 , 000 COMMERCIAL GENERAL LIABILITY DAMAX REMI O N PREMISES Ea occurrence $1, OOO , OOO CLAIMS-MADE X❑ OCCUR MED EXP (Any one person) $10 , 000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $1, 000, 000 POLICY PRO X LOC JrCT A AUTOMOBILE LIABILITY 7353 0237 12 31 201012.31.2011 COMBINEDSINGLELIMIT Ea accident .. $1,000,000 BODILY INJURY (Per person) X ANY AUTO - - - ALL OWNED AUTOS BODILY INJURY (Per accident) SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS Per accident NON OWNED AUTOS B X UMBRELLA LIM EXCESS LIAB H OCCUR CLAIMS -MADE m00539375002 SIR applies per policy terns 12 31 201012 & conditions 31 2011 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 DEDUCTIBLE X RETENTION S10,000 C WORKERS COMPENSATION AND _'EMPLOYERS'LIABILITY* Y/.N ANY PROPRIETOR / PARTNER / EXECUTIVE wccz91451053010 - 12/31/201012/31/2011 �( WC ST T - oTH- ER E.L. EACH ACCIDENT $1, 000-j O00 OFFICEPJMEMBER EXCLUDED? N (Mandatory in NH) N I A E.L. DISEASE -EA EMPLOYEE $1, 000 , 000 if yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1, 000 , 000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Fort Collins is added as an Additional Insured excluding workers' Compensation and Employer's Liability policy as required by written contract but limited to the operations of the Insured under said contract and always subject to the policy terms, conditions and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins AUTHORIZED REPRESENTATIVE Attn: Lance Murray PO Box 580 Fort Collins Co 80522 USA CO N rn v 0 LO ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD