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445046 PATTON BOGGS LLP - INSURANCE CERTIFICATE (5)
A CERTIFICATE OF LIABILITY INSURANCE °AL0ISM"�0t1 "' THIS CERTIFICATEIS 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 INSUREFI 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 Ann Risk Services Northeast, Inc. New York NY Office CONTACT NAME: __ (wc No. Exq; <866) 283-]122 aC Nc.: (847) 953-5390 E-MAIL ADDRESS: 199 Water Street _ ____ New York NY 10038-3551 USA INSURER(S) AFFORDING COVERAGE NAIC% S C INSDRED INSURER A: Federal Insurance Company 20281 PdiiOn Boggs LLP 2550 M Str'e et, N.W. WdShl ngtOn DC 20037-1350 USA INSURER B: Vigilant Ins CO 20397 INSURER C: Great Northern Insurance Co. 20303 INSURER D: INSURER E: WSURER F: COVERAGES CERTIFICATE NUMBER: 570042440029 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. Limits shown are as requested LBRI TR TYPE OF INSURANCE INSR WVD POLICY NUMBER POLICY EFF MMI00 MMHDDPffYYI LIMITS B GENERAL LIABILITY EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY Package Policy PREMISES Ea occurrence $1,000,000 CLAIMS -MADE OCCUR MED EAR (Any one peron) $10,000 % Prod-Comp/Op Intl in Genf A99, PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 "GEN'L AGGREGATE LIMIT APPLIES PER - PRODUCTS - COMPIOP ADD POLICY PRO- LOO , A AUTOMOBILE LIABILITY 74986701 Automobile Policy 10 01 201010 01 2011 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY( Per person) ',],ANY AUTO BODILY INJURY (Per accu ll ALL OWNED SCHEDULED AUTOS AUTOS HIREDAUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Peracudenl A % OCCUR 93630074 10/01/2010 10/01/2011 EACH OCCURRENCE $5,000,000 HUMBRELLALIAB EXCESS LIAR CLAIMS -MADE Umbrella Policy AGGREGATE $5,000,003 DED RETENTION C WORKERS COMPENSATION AND fMPLovEgS'LIAEILITY Y/N ANv PROPRIETORIPARTrvE R /ExEcuTNE ❑ OFFICERIMEMBER E%CLUOEDi (Mandatory In NHl NIA 71721244 WOr'kers� compensation POi 05/01/2011 05/01/2012 WO STATU- OT14 X TORY LIMITB _ OTH- ' E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1, 000, 000 u yee aeecdde maer DESCRIPTION OF OPERATIONS bclpw E.L. D15EASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101. Additional Remar,a Schedule, If more space is required) Evidence Of insurance coverage in force. `v 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. The City Of Fort Collins, Colorado, AUTHORIZED REPRESENTATIVE A Municipal Corporation P.O. Box 580 Fort Collins Co 80522 USA �y ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD