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HomeMy WebLinkAbout462625 PEAK LEADERSHIP CONSULTING - INSURANCE CERTIFICATE173147 ACC " CERTIFICATE OF LIABILITY INSURANCE DAT 6/5/DDIYVri) 6/5/2012 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 Commercial Lines - (330) 726-8861 Wells Fargo Insurance Services USA, Inc. CONTACT Linda McLaughlin NAME: 9 PHONE 330-729-2632 I FAX 330-726-8997 .WC. No. Ext): INC, Nm: EMAIL o.coml d na.mcau hlin wellsfar ADDRESS: Li9 @ g INSURERS AFFORDING COVERAGE NAICIf 8561 Market Street INSURERA: American Casualty Company of Reading, PA 20427 Youngstown, OH 44512-6727 INSURED I I / y� INSURER B: Hartford Accident and Indemnity Company 22357 Peak Leadership Consulting (.4t/ INSURER C: INSURER D: 4548 Seaway Circle INSURER E: I INSURER F : Fort Collins, CO 80525 COVERAGES CERTIFICATE NUMBER: 4429157 REVISION NUMBER: See below 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.. 1NSR TYPE OF INSURANCE AINSWVD OOL SUER POLICY EFF POLICY EXP TR POLICY NUMBER MMIDD YVYY MM DDIVYYY LIMITS A GENERAL LIABILITY X COM MERCIAL ER X 4030752651 06/10/2012 06/10/2013 EACH OCCURRENCE DAMAGETO RENTED $ 1,000,000 000,000 CLAIMS-MADE� OCCUR MED EXP (Any one Person) $ PERSONAL S ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,13D0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 2.ID0.000 _X1 POLICY F-1 PRO- n LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea ac_cidem $ 1,000,000 BODILY INJURY (Per Person) $ ANY AU 10 ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ % PROPERTY DAMAGE (Peracudent) $ A NON -OWNED HIRED AUTOS % AUTOS X 4030752651 06/10/2012 06/10/2013 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMSMADEAGGREGATE $ $ DED RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNEWEXECUTIVE 45WECVY2321 06/01/2012 06/01/2013 X WCVTATU�OTH- LIMIT E.L. EACH ACCIDENT $ 10D,000 OFFICEP/MEMBER EXCLUDED? (Mandatory in NH) NIA E.L. DISEASE - EA EMPLOYE E 500,000 If yes desento under DESCRIPTION OF OPERATIONS Wl. E.L. DISEASE - POLICY LIMIT $ 100.D00 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) City of Fort Collins is Additional Insured. Reference form SB300120B 0410. .eacLea�rauacl City Of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn: Purchasing THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE � /// Iry 'f � The ACORD name and logo are registered marks of ACORD © 1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) 1111111111111111111111111111111111111111011111111111111111 I 111111111 .vealar'.0xv M0r0r0.