Loading...
HomeMy WebLinkAboutCLEVER DEVICES LTD - INSURANCE CERTIFICATEOP ID: SM ,a►ACo,Mo CERTIFICATE OF LIABILITY INSURANCE OAT04/26DYYYY) 4/26/12 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 516-465-0200 INSIGHT COMPANIES INC. 516�65-0201 125 East Bethpage Road Plainview, NY 11803 John R.Keane CONTACT Selma Miller ' PRONE 516-465-0200 ac No: 516-465-0201 (AIC No ,at), ADDRESS Smiller@insightins.com PRODUCER CLEVE-1 CUSTOMER ID;k INSURERS AFFORDING COVERAGE NAIC p INSURED , -P Clever Devices, Ltd. INSURER A: Netherlands Insurance Co. 24171 INSURERS: Peerless Insurance Company 24198 137 Commercial St. Plainview, NY 11803 INSURER C: Excelsior Insurance Company 11045 INSURER D:American Casual Comps 015 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. INSR LTR rypE OF INSURANCE I O BRA POLICY NUMBER POLICY EFF MM/DDVYYYY POLICY EXP MM IOD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxI OCCUR CBP8524608 10/07/11 10/07/12 EACH OCCURRENCE $ 1,000,00 PREMISE$ Ea occurrence $ 300,00 MED EXP (Any one person) $ - 10,00 PERSONAL B ADV INJURY $ - 1,000,00 GENERAL AGGREGATE $ 2,000,00 GENL AGGREGATE LIMIT APPLIES PER. POLICY X PRO- LOC PRODUCTS - COMP/OP AGG $ 2,000,00 1 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BA8524708 10/07/11 110/07/12 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY OAMAGE (Peraccidenl) $ X X $ $ C UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS -MADE CU8524808 10I07111 10I07112 OCCURRENCE $ 10,000,00 EGATE $ 10,000,000 DEDUCTIBLE RETENTION $ 10,000 $ X $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WC414285746 10/07111 10/07/12 C STATUS OTHDRY L- IMITS ER iLDISEASE CH ACCIDENT $ 600,00 SEASE - EA EMPLOYEE $ 500,000 -POLICY LIMIT 1 $ 500,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional RemarMe Schedule, If more space Is required) Evidence of Insurance CITYOFF City of Fort Collins,Financial Services, Purchasing Division 215 N. Mason St., 2nd FI. PO Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 4 �O14R © 1988.2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD