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HomeMy WebLinkAbout144217 CCMSI HOLDINGS INC - INSURANCE CERTIFICATE (2)menra: otuot twtambnul ACORD.CERTIFICATE OF LIABILITY INSURANCE CERTIFICATE DATE 07/30/200/2011 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(les) 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 Mackey Team Mesirow Insurance Services, Inc. 353 N. Clark Street Chicago, IL 60654 CONTACT Leah Cozad NAME: PNN2N 0 Eat): 312 595.7142FAX AC, No: E-MAIL ADDRESS: INSURERS) AFFORDING COVERAGE NAIL r INSURER A: Charter Oak Fire Insurance Comp 25615 INSURED CCMSI Holdings, Inc 2 East Main Street, Suite 208 Towne Centre Building Danville, IL 61832 INSURER B : Travelers Property/Casualty 25674 INSURERC: Farmington Casualty Company 41483 INSURER D: Navigators Specialty Insurance 36056 Lexington Insurance Company INSURER E: 9 P Y 19437 INSURER F COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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 AODLSUBR INSR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MINI LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FXI OCCUR P6301918P719COF10 11/17/2010 11/17/2011 $1 OOOOOO pEDAApC,CM1HHq�OEECCCTURRRRENCE PREMISESOEe occurrence $100000 MED EXP (Any one person) s5,000 PERSONAL& ADV INJURY $1,000000 GENERALAGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO X1 LOC PRODUCTS - COMP/OP AGO $2,000,000 $ A AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X HIRED AUTOS X NON -OWNED AUTOS P8101918P719COF10 11/17/2010 11/17/2011 COMBINED SINGLE LIMIT Ea amident 1,000,000 BODILY INJURY (Per Person) $ BODILY INJURY (Per acdtlem) $ PROPERTY DAMAGE Peracddent $ 8 B X UMBRELLAUAB EXCESS UAB OCCUR CLAIMS -MADE PSMCUP1918P71909TI 11/17/2010 11/17/2011 EACH OCCURRENCE $10000000 AGGREGATE $1 O 00O 000 DED I X RETENTION $10000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE Y I N OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yyes. descrito under DESCRIPTION OF OPERATIONS below - NIA PFU81918P71910 11/17/2010 11/17/2011 X we sTATu- OTH- TS FIR E.L. EACH ACCIDENT $1 000 000 E.L. DISEASE -EA EMPLOYEE $1 00O 000 E.L. DISEASE -POLICY LIMIT $1,000,000 D E E&O - Primary $5M E&O - $SM XS $SM NY11 MPL0007121C 006761856 7/31/2011 7/31/2011 07/31/201 07/31/201 $5M Occl$5M Agg $5M Excess DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is required) Certificate holder is named as additional insured under the automobile liability and general liability for work performed by the insured, only as required by written contract. City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O. Box 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522-0000 AUTHORIZED RREPRESENTATIVElN ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD