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HomeMy WebLinkAbout133946 HOME DEPOT - INSURANCE CERTIFICATEA� " CERTIFICATE OF LIABILITY INSURANCE D02/18IDD/Y1 02/18/2011 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 1-404-995-3000 Marsh USA, Inc. CONTACT , NAME: PHONE FAX INC.No. Exl : INC, No): E-MAIL ADDRESS: homedepot.Certrequest@marsh.com Two Alliance Center, 3560 Lenox Road, Suite 2400 Atlanta, GA 30326 INSURERS AFFORDING COVERAGE NAIC# INSURER A: Steadfast Ins Cc 26387 Fax (212) 948-0902 INSURED INSURER B: Zurich American Ins CO 16535 Home Depot U.S.A., Inc. d/b/a The Home Depot INSURERC: New Hampshire Ins Co 23841 INSURER D: Illinois Natl Ins Co 23817 2455 Paces Ferry Road Building GA 3 Atlanta, GA 0339 INSURER E: NATIONAL UNION FIRE INS CO OF PITTS 19445 INSURER F: Illinois Union Ins Cc 27960 COVERAGES CERTIFICATE NUMBER: 1981G305 REVISION NUMBER: 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 ADDL SUER POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DD/VYVY LIMITS A GENERAL LIABILITY GL04887714-01 03/01/1 03/01/12 EACH OCCURRENCE S 91000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 CLAIMS -MADE O OCCUR MED EXP (Any one person) $ EXCLUDED PERSONAL&ADV INJURY $ 91000,000 X LIMITS OF POLICY XS X OF SIR: $lM PER OCC GENERAL AGGREGATE $ 9,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $9,000,000 X1 POLICY PRO- LOC $ B AUTOMOBILE LIABILITY HAP 2938863-08 03 Ol 1 03 01 12 COMPINED SINGLE LIMIT - Ea accident $ 1,000,000 BODILY INJURY (Per person) S X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $' PROPERTY DAMAGE NON -OWNED HIRED AUTOS AUTOS Per accident) $ X SIR AUTO P $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ IS C WORKERS COMPENSATION WC061967352 (ADS) 03/01/1 03/01/12 X OU- DTH- TRY T RY UN AND EMPLOYERS' LIABILITY YIN E.L. EACH ACCIDENT S 1,000,000 D PROPRIETOR/PARTNER/EXECUTIVE WC061967354 (FL) 03/01/1 03/01/12 OFFICER/MEMBER EXCLUDED? K, N / A E.L. DISEASE - EA EMPLOYE $ 1, 000, 000 E (Mandatory in NH) WC061967353 (CA) 03/01/1 03/01/12 If yes, describe under E.L. DISEASE - POLICY LIMIT S 1, 000, 000 DESCRIPTION OF OPERATIONS below C Workers Compensation WC061967355(KY,M0,NY,WI, D3/01/1 03/01/12 F TX Employers XS Indemnity TNSC46244151 (TX) 03/01/1 03/01/12 Occurrence/SIR 30M/lM E Workers Compensation WC1192378 (QSI) 03/01/1 03/01/12 SIR 1M DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CITY OF FORT COLLINS IS INCLUDED AS AN ADDITIONAL INSURED IF REQUIRED BY WRITTEN CONTRACT ON THE ABOVE GENERAL LIABILITY POLICY, BUT ONLY WITH RESPECT TO LIABILITY ARISING OUT OF THE OPERATIONS OF THE NAMED INSURED. Imo,-rl� Ilvr.v Lr� VNIYV CL L/i 11V IY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF FORT COLLINS THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 281 NORTH COLLEGE AUTHORIZED REPRESENTATIVE FORT COLLINS, CO 80524 USA ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD . Jthornton_hd - - - - - - 19810305 ADDITIONAL INFORMATION DALEoz/18/2o11B/zu PRODUCER COMPANIES AFFORDING COVERAGE Marsh USA, Inc. homedepot.certrequestOmarsh.com Two Alliance Center, 3560 Lenox Road, Suite 2400 Atlanta, GA 30326 INSURED Home Depot U.S.A., Inc. d/b/a The Home Depot' 2455 Paces Ferry Road Building C-20 Atlanta, GA 30339 Workers Compensation Continued: Carrier: National Union Fire Insurance Company Policy No.: WC1192379 (MA) Policy Dates: 03/01/2011 7 03/01/2012 Limit: $1,000,000 SIR: $500,000 **' HOME DEPOT INSUREDS... Home Depot Q.S.A., The Home Depot, Inc. Entity List COMPANY Illinois Union Ins Cc COMPANY G COMPANY H Chem -Dry Limited Harris Research, Inc. HD Direct LLC Home Depot Installation Services, Inc. Home Depot USA, Inc. dba The Home Depot THD At Home Services, Inc. dba The Home Depot At -Home Services THD At -Home Services, Inc. The Home Depot, Inc. The Home Depot, Inc. Home Depot USA,, Inc. Your Other Warehouse, LLC CERTIFICATE HOLDER CITY OF FORT COLLINS 281 NORTH COLLEGE FORT COLLINS, CO 80524 USA MARSH USA INC.BY / �--- Page 2