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HomeMy WebLinkAbout432987 MBI CONSULTING LLC - INSURANCE CERTIFICATE (3)MBICO.1 OF ID: BA AI`dR�µ CERTIFICATE OF LIABILITY INSURANCE DAT06123 DIYYYY) F O6/23/11 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 endorsements . - PRODUCER 970-635-9400 PFS Insurance Group -JT 4848 Thompson Pkwy, Ste 206 970-635-9401 CONTACT PHONE A/C, No Est); A/C No Johnstown, CO 80534 TLC -Special Accounts EMAIL ADDRESS: INSURERIS) AFFORDING COVERAGE NAIC If INSURER A: EMC Insurance Companies INSURED MBI Consulting, LLC PO Box 2085 INSURER8: Pinnacol Assurance Co 41190 Fort Collins, CO 80522 INSURER C INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NIIMRFR- 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 ADOL SUBR POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY E%P MMIDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,006 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE lxl OCCUR X 31384658 02/04111 02/04112 DAMAGE TO RENTED PREMISES Ea occurrence $ 50,000 MED EXP(Any one person) $ 5,000 PERSONAL aADV INJURY $ 1,000,00 BLANKET ADD'L INSURED GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY F PRO 1-1 LOG $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Peraccinenl $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ Id AGGREGATE $ EXCESS LIAB CLAIMS MADE DED RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED9 ❑ NIA 4106693 07101/11 07101112 X WC STATIU OTH- T OR,LIMIT ER E.L. EACH ACCIDENT $ 100,000 EL DISEASE - EA EMPLOYEE $ 100,000 (Mandatory In NH) - If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) All Locations / All Operations CITYOF3 City of Fort Collins PO Box 580 Fort Collins„ CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD