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HomeMy WebLinkAbout144217 CCMSI HOLDINGS INC - INSURANCE CERTIFICATECCMSHOL Client#: 67967 ACORD. CERTIFICATE OF LIABILITY INSURANCE D1111612011AM Y 11I16I2011 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 endomement(s). PRODUCER Mackey Team Mesirow Insurance Services, Inc. 353 N. Clark Street Chicago, IL 60654 TA NAME: Or Leah Cozad PHONE 312 595-7142 312 595-7163 A/C No Es : (IC No: E-tAAll ADDRESS: lcozad@mesirowfinancial.com INSURERS) AFFORDING COVERAGE NAICi INSURER A: Charter Oak Fire Insurance Comp 25615 INSURED INSURER B: Travelers Property Casualty Co. 25674 CCMSI Holdings, Inc INSURERC: Travelers Indemnity Co. of Amer 25666 2 East Main Street, Suite 208 Towne Centre Building Danville, IL 61832 INSURER D: Specialty Navigators S Insurance Pe tY 36056 n INsuRERE:LexingtonInsurance Company 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. VTR TYPE OF INSURANCE IINSR MID POLICY NUMBER Mt°VDDY EFF MhWDf EXP LIMITS A GENERAL LIABILITY X COMMERCIALGENERALLIABIUTY - CILAIMSMADE 51OCCUR P630191 8P719COF1 1 11/17/2011 11117/2012 EACH OCCURRENCE $1000000 PREMISESOEeEo �urrenm YIOO OOO MEDEXP(My one person) $5000 PERSONAL &ADV INJURY $1,000000 GENERALAGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- X LOC JECT PRODUCTS-COMP/OPAGG $2,000,000 $ A AUTOMOBILELIABILDY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X HIRED At X NON -OWNED AUTOS P8101918P719COF11 11/17/2011 11/1712012 EOMaBBIIN�EDtSINGLELIMIT $1,000,000 BODILY INJURY (Per Peeon) $ BODILY INJURY (Per amdent) $ PROPERTY DAMAGE Per ectldent $ E B X UNBRELLA LLIB EXCESS LIAR 1( OCCUR CLAIMS -MADE PSMCUP1918P71909TI 11/17/2011 11/1712012 EACH OCCURRENCE $10000000 AGGREGATE $10000 000 DED I X1 RETENTION$10000 $ C WORIER9 COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOWPARTNER/EXECUTIVW OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe ur der DESCRIPTION OF OPERATIONS below NIA PHUB1918P71911 11/17/2011 11/17/201 X WC STATu- oTH- E.L. EACH ACCIDENT $1 OOO OOO E.L. DISEASE - EA EMPLOYEE $1 000000 E.L. DISEASE -POLICY LIMIT $1 000,000 D E E&O- Primary $5M E&O - $5M XS $5M NYI I MPL0007121C 006761856 /31/2011 F/31/2011 07/31/201 07/31/201 $5M OCC/$5M Agg $e/ M Excess DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Addkonal Remarlre Schedule, it mom seam 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 P.O. Box 580 Fort Collins, CO 80522-0000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORMD REPRESENTATIVE ACORD 25 (2010105) 1 of I #S1040098/M1040049 ©1988.2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD LZC