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HomeMy WebLinkAbout451613 EMPLOYERS EDGE LLC - INSURANCE CERTIFICATE (4)EMPLO-2 OP ID: SO ,40Coszo CERTIFICATE OF LIABILITY INSURANCE DAT06/15DYYYY) osn sn 1 PRODUCER 303-322-0800 Madison Insurance Group 425 S. Cherry St, #420 Denver, CO 80246 Thomas R Young THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Employers Edge LLC 2755 S Locust -St #119 Denver, CO 80222 INSURER A: Hartford Insurance Company 0006 INSURER B' INSURER C. INSURER D. INSURER E'. nnVFRAnFR 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADD'L INSRO TYPE OF INSURANCEGENERAL POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LIABILITY EACH OCCURRENCE $ 2,000,00 A X X COMMERCIAL GENERAL LIABILITY 34SBARV1642 06/01/11 06/01/12 DAMA ETORENTED PREMISES Ea NTEDnce $ 300,00 CLAIMS MADE 7 OCCUR MED EXP (Any one person) $ 10,00 PERSONAL B ADV INJURY $ 2,000,00 GENERAL AGGREGATE $ 4,000,00 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 4,000,00 POLICY F_j PRO n LOC A AUTOMOBILE LIABILITY ANY AUTO 34SBARVI642 06/01/11 06/01/12 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY. AGG EXCESS UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ E E DEDUCTIBLE $ RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? WC STATU- OTH TCRY L" E.L. EACH ACCIDENT $ (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ OTHER C Professional Lie PHSD420657 06/01/11 06/01/12 Clms Made 1,000,00 D Cyber Security List PHSSD582724 12/10/10 12/12/11 Cyber Cvg see note DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVSIONS SHOULD ANY OF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN City of Ft. Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TOTES LEFT, BUT FAILURE TO DO SO SHALL Purchasing Division 215 N Mason, 2nd Floor IMPOSE NO OBLIGATION OR LIABILITY OF ANY HIND UPON THE INSURER, ITS AGENTS OR Ft Collins, CO 80522 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD EMPLO-2 OP ID: SD 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. ACORD 25 (2009/01) No Text ACORO' PRODUCER Madison Insurance Group 425 S. Cherry St, #420 Denver, CO 80246 Thomas R Young INSURED nnVFRAn9A EMPLO-2 OP ID: SD CERTIFICATE OF LIABILITY INSURANCE DATE IMIARDO'YYY) 06/15/11 303-322-0800 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE INSURERS AFFORDING COVERAGE NAIC IIIC INsuRERA Hartford Insurance Company 0006 19 INSURER B'. INSURER D'. 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L LUM TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS _LIEL GENERAL LABILITY EACH OCCURRENCE $ 2,000,00 A X X COMMERCIAL GENERAL LIABILITY 365BARV1642 06/01/11 06I01/12 DAMA LTNTED PREMISES E.Eoccuence $ 300,00 CLAIMS MADE OCCUR MED EXP (Any one person) E 10,00 PERSONAL 4 ADV INJURY $ 2,000,00 GENERAL AGGREGATE E 4,000,00 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 4,000,00 POLICY 0 PRO LOC A AUTOMOBILE LABILITY ANY AUTO 34SBARV1642 06/01/11 06/01/12 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) E HIRED AUTOS NON -OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO E AUTO ONLY: AGG E%CESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR F-ICLAIMS MADE AGGREGATE $ $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION WC STATU- OTH- EN AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECU➢VE ❑ OFFICERRAEMBER EXCLUDED? E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE E (Mendetory In NH) It yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT E OTHER C Professional Lia PHSD420657 06/01/11 06/01/12 Clans Made 1,000,00 D Cyber Security Lia PHSSD582724 12/10/10 12/12/11 Cyber Cvg see note DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN City of Ft. Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Purchasing Division 215 N Mason, 2nd Floor IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Ft Collins, CO 80522 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2009/01) 11988.2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD EMPLO-2 OP ID: SD 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. ACORD 25 (2009/01) No Text EMPLO-2 OP ID: TBD ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(M19D/Y/11 09/1 PRODUCER 303-322-0800 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Madison Insurance Group ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 425 S. Cherry St, #420 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Denver, CO 80246 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Thomas R Young INSURERS AFFORDING COVERAGE NAIC # INSURED Employers Edge LLC INSURER A: Hartford Insurance Company 0006 2755 S- Locust -St #119 Denver, CO 80222 INSURER B: INSURERC: Philadelphia Insurance Co 006 INSURER D: Philadelphia Insurance Co 006 COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR DD'L POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YYYY POLICY EXPIRATION DATE MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A X X COMMERCIAL GENERAL LIABILITY 34SBARV1642 06/01 /11 06101 /12 DAMAGE TO RETE PREMISES(E. occurence) $ 300,000 CLAIMS MADE F—IOCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 4,000,000 POLICY PRO LOC A AUTOMOBILE LIABILITY ANY AUTO 34SBARV1642 06/01 /11 06/01/12 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR F—ICLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N WC STATU- OTH- TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER C Professional Lia PHSD420657 �PHSSD582724 06/01/11 06/01/12 Clms Made 1,000,000 D Cyber Security Lia 12/10/10 12/12/11 Cyber Cvg see notes DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS City of Fort Collins is included as Additonal Insured with respect to General Liability of the Name Insured CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN City of Ft. Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Purchasing Division IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 215 N Mason, 2nd Floor REPRESENTATIVES. Ft Collins, CO 80522 AUTHORIZED REPRESENTATIVE / T JEJm<k9(,7 �, PC 1�,Aty1f�, ACORD 25 (2009/01) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD EMPLO-2 PAGE 2 NOTEPAD iNSURED•S NAME Employers Edge LLC OP ID: TBD DATE 09/19/11 cal Business lnteruption & Extra Expense $1,000,000 )rtion Threat $1.000.000 ork SEcurity & PRIg6 Liability $1,000,000 oyee Privacy Liability1 000 000 ronic Media_Liabili% $ 40,d00 r Terrorism $1.000.000