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HomeMy WebLinkAboutRAND SCOT INC MOBILITY LTD - INSURANCE CERTIFICATE (2)CERTIFICATE OF LIABILITY INSURANCE OP ID DA DATE(MMDDYYYY) O1 26 12 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 NAME: PHONE FtX A/ ERI)'. (AIC, No): Brown & Brown Inc 4532 Boardwalk Dr, Suite 200 Fort Collins CO 80525 AIL ADDRESS: CUSTOMERIDN: RANDS-1 Phone:970-482-7747 Fax:970-484-4165 INSURERS) AFFORDING COVERAGE NAICH INSURED INSURER A: Republic Indemnity co of Cx 43753 Rand -Scot Inc & Mobility Ltd Saratoga Access & Fitness & INSURER : Federal Insurance Company 20281 INSURER c: Hartford Underwriters Ins co 30104 Resource Medical Systems, Inc. Joel & Barbara Lerich Indiv. 401 Linden Center Drive INSURER D: INSURER E: Ft Collins CO 80524 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. IHSRR TYPE OF INSURANCE NSR SUBADD POLICY NUMBER POLICY POLICY EFF (MM/DDTYYYYI POLICY EXP (MMIDDTYYYY) LIMITS B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY X CLAIMS -MADE OCCUR 35818332WCE 35818333WCE 03/17/12 03/17/12 03/17/13 03/17/13 EACH OCCURRENCE $ 1,000,000 PREMISES (Ed occurrence)s1,000,000 MED EXP(Any one person) $10,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY n JECT LOC PRODUCTS - COMP/OP ADD $Excluded $ C AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 34UECTZ5427 01/17/12 01/17/13 COMBINED SINGLE LIMIT (Ea accident) 1,000, 000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 79839892 03/17/12 03/17/13 EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 X I DEDUCTIBLE RETENTION $ 0 S $ A- WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNEWEXECUTIVG� OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 1310930118 - 04/01/11 04/01/12 X TORY LIMITS ER E.L. EACH ACCIDENT $1, 000, 000 E.L. DISEASE - EA EMPLOYEE $ 1, 0 0 0 , 0 0 0 E. L. DISEASE -POLICY LIMIT $1, 000, 000 C Product Liability Retro 1/17/04 35818333WCE CLAIMS -MADE 03/17/12 03/17/13 Each Occu 2,000,000 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace is required) Certificate holder included as additonal insured for general liability. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITYFCB I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins AUTHORIZED REPRESENTATIVE 300 LaPorte Ave I ___� ACORD CORPORATIC" All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD