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Home My WebLink About432987 MBI CONSULTING LLC - INSURANCE CERTIFICATEOP ID: BA ,4`�tzo CERTIFICATE OF LIABILITY INSURANCE °ATovZ3i12 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 970-635-9401 4848 Thompson Pkwy, Ste 200 Johnstown, CO 80534 Johnstown Select Accounts CONTACT NAME: (HONE NC No: AIC Ezt: IL ADREss: PRODUCER MBICO-1 CUSTOMER ID a: INSURER $ AFFORDING COVERAGE NAIC Y INSURED MBI Consulting, LLC PO Box 2085 INSURER,: EMC Insurance Companies INSURER B: Pinnacol Assurance 524210 INSURER C Fort Collins, CO 80522 INSURER °: INSURER E INSURER F COVERAGI=S t izmi Irvimea 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 GENERAL LIABILITY CLAIMS -MADE � OCCUR ADDL SUMR POLICY NUMBER BLANKET ADD'LINSURED POLICY EFF MMIDDIYYYV 021041112 POLICY EXP MMIDDNYYV 02/04113 LIMITS EACH OCCURRENCE- $ 1,000,00 DAMA ET R NTED S Eaoccurrence E 50,000 MED EXP (Any one person) $ 5,00 PERSONAL SADVINJURY $ 1,000,00 GENERAL AGGREGATE S 2,000,000 PRODUCTS - COMPIOP AGO $ 2,000,00 GENT AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO NIA BODILY INJURY (Per person) It BODILY INJURY (Per accident) $ ALL OWNED AUTOS PROPERTY DAMAGE (Per accident) S SCHEDULED AUTOS HIRED AUTOS E NON -OWNED AUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS -MADE NIA AGGREGATE $ $ DEDUCTIBLE RETENTION E WORKERS COMPENSATION WC STATU- OTH- X T IM T R E.L. EACH ACCIDENT $ 100,000 B AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4106693 07/01111 07/01112 EL DISEASE -EA EMPLOYEE $ 100,00 E.L. DISEASE -POLICY LIMIT $ 500,00 NIA DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Anach ACORD 101, Additional Remarks Schedule, If more apace Is required) All Locations / All Operations CITYOF3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins PO BOX 580 AUTHORIZED REPRESENTATIVE Fort Collins„ CO 80522 n IORR-1nn9 ACORD ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD All rights reserved.