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Home My WebLink AboutHAYS COMPANIES - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE 01/18/201YYY) Ol/18/2012 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 1-612-333-3323 CONTACT NAME: Cheryl SOhn90R OS Melody RLOnbdCh Hays Companies PHONE 612-333-3323 FAX 612-373-7270 AIC N EXl AIC No E-MAIL ADDRESS: 80 South 8th Street PRODUCER HAYSG-2 CUSTOMERIOA' Suite 700 Minneapolis; MN 55402 INSURER 5 AFFORDING COVERAGE NAIC If INSURED INSURER A: CHARTER OAR FIRE INS CO 25615 Hays Companies INSURER B: TRAVELERS PROP CAS CO OF AMER 25674 INSURER C: STANDARD FIRE INS CO 19070 80 South 8th Street, Suite 700 INSURER D: Minneapolis, MN 55402 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 25224800 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. INSR LTR TYPE OF INSURANCE ADOLSUBR POLICY EFF POLICY EXP INSR MD POLICY NUMBER MMIDDIYYYY) IMMUDDNYYYI LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I] OCCUR 6301B851993 01/19/1 01/19/13 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 MED EXP(my one person) S 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE X POLICY LIMIT APPLIES PER: PRO- n LOG PRODUCTS - COMPIOP AGG S 2,000,000 S A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMP/COLL $500 8101BBS1993 01/19 1 01/19/13 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) S BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ X $ B X UMBRELLA LIAB EXCESS LIAR X OCCUR CLAIMS -MADE CUP1B851993 01/19/1 01/19/13 EACH OCCURRENCE $ 20,000, 000 AGGREGATE $ 20, 000, 000 DEDUCTIBLE RETENTION $ $ b C WORKERS COMPENSATION ANDEMPLOYERS' LIABILITY YIN ANYCERIMEMBERIPAR'NERIEXECUTIVE OFFICER/MEMI OR EXCLUDED9 h (Mandate, in NH) It yes, describe untler DESCRIPTION OF OPERATIONS below NIA UHIBB51993 O1/19/1 01/19/13 X WC STATU- OTH- TLIMITS LEACH ACCIDENT E 1,000,000 EL DISEASE -EA EMPLOYE $ 1, 000,000 E.L. DISEASE -POLICY LIMIT $ 1, 000, 000 A Property 6301B851993 BLRT BPP , DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) The City, its officers, agents and employees shall be named as additional insureds on the general liability and automobile liability insurance policies for any claims arising out of work performed under this Agreement. nvi-vcm L,HINUMLLH 1 I VN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Port Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 AUTHORIZED REPRESENTATIVE p Fort Collins, CO 80522 USA �✓J' chjohnson O 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD 25224800