HomeMy WebLinkAboutMERLIN GRUE INVESTIGATIVE AND CONSULTING SERVICES - INSURANCE CERTIFICATE (3)Rb® CERTIFICATE OF LIABILITY INSURANCE OP ID GC
DnrE (MMI2
19/11)
OB 1
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 Robertson.-_�.;."yY.
Y Assoc., Inc.
NAME� -
_.
TwoPlazaEast�&
y "Suite 65D
AIC, No. Ezt: __.._ (A/C,
ADDRESS:
330'East' Rilbourn"Avenue
FIR UV EK
CUSTOMERIDa: MERLI-1
Milwaukee-WI--53202---
Phone:414-271-3575 Faz:414-271-0196
INSURER(S)AFFORDINGCOVERAGE. __ -_. �..-__..
NAICIt
INSURED
INSURER A: National Specialty Ini
Merlin Grue Investigative
and Consulting Services
2760 East Adams Ct., Apt. #7
Cudahy WI 53110
INSURER B:
INSURER C:
INSURER D
INSURER E :
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 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.
LTR
TYPE OF INSURANCE
INSR
MD
POLICY NUMBER
(MMIDD/YYYY)
(MMI)D/YYYY)
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE �X ,OCCUR
NSWO699592
02/10/11
-
,
02/10/12
.. _.
-
EACH OCCURRENCE
$ 100000
PREMISES (Eaoccurrence)
$ 100000
MEDI(Anyone person) ,-.
$ 5000 _
PERSONAL Ii INJURY, _
-$-10000.0
.GENERAL AGGREGATE __
$. 200000Q-__ _
GEN'L AGGREGATE LIMIT APPLIES PER:
JE
X I POLICY [7 PRCTO LOG
PRODUCTS - COMP/OP AGO_
$200000
— -
AUTOMOBILE
LIABILITY.:
' -
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
-
COMBINED SINGLE LIMIT
(Ea accitlent)
$ _
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
$
$
UMBRELLA LIAB
EXCESS LIAR
OCCUR
CLAIM&MADE
-
EACH OCCURRENCE
$
AGGREGATE
$
DEDUCTIBLE
RETENTION. $
$
WORHERSCOMPENSATION AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNERIEXECUTIVI
OFFICEWMEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
I A
TORY LIMITS ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
EL.DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required)
Dectective Agency w/o Firearms
CERTIFICATE HOLDER CANCELLATION
City of Fort Collins
215 N., Mason Street
Fort Collins CO 80521
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
CITYFOR I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
ACORD 25 (2009109)
The ACORD name and logo are registered marks of ACORD
reserved