The URL can be used to link to this page

Home My WebLink About144217 CCMSI HOLDINGS INC - INSURANCE CERTIFICATE (3)Client#: 67967 CCMSHOI ACORDTM CERTIFICATE OF LIABILITY INSURANCE DTE 7/31/2IDDIYYVY) /31/2012 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 CONTACT NAME: Leah Cozad Mackey Team PAIC HONE 312 595-7142 FAX 312 595.7163 E#: AICNo: , Mesirow Insurance Services EMAIL IL ADDRESS: Icozad@mesirowfinancial.com 353 N. Clark Street Suite 1200 INSURER(S)AFFORDING COVERAGE NAICp Chicago, IL 60654 INSURER A: Charter Oak Fire Insurance Comp 25615 INSURED INSURER B: Travelers Property Casualty Co. 25674 CCMSI Holdings, Inc INSURER C: Y rave Tlers Indemnity Co. of Amer 25666 2 East Main Street, Suite 208 Federal Insurance Company INSURER 0: P Y 20281 Towne Centre Building Navigators S ecialt Insurance INSURERE:Specialty 36056 Danville, IL 61832 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 CONTRACTOR 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 ADDLSUBR INSR MD POLICY NUMBER POLICY EFF MMIDDIYYYV POLICY EXP MMIDDIYYYY LIMITS A GENERAL LIABILITY P6301918P719COF11 11/17/2011 '11/'17/201 EACH OCCURRENCE $1,000000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 5XIOCCUR PREMISESOEa oncconDence $100,000 MED EXP(Any one person) $5,000 PERSONAL &ADV INJURY 1$1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $2,000,000 POLICY PRO X LOC JECT $ A AUTOMOBILE LIABILITY P8101918P719COF11 11/17/2011 11/17/201 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO IX ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident)$ PROPERTY DAMAGE Per accident $ HIRED AUTOS X NON -OWNED AUTOS B �( UMBRELLA LIAR OCCUR PSMCUP1918P71909TI 11/1712011 11117/2012 EACH OCCURRENCE $10000000 El AGGREGATE $1000O 000 EXCESS LIAB CLAIMS -MADE DED I X RETENTION $10000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y I N ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? NIA PHUB1918P71911 11/1712011 11/17/2012 X WCSTATU- OTH- IM E.L. EACH ACCIDENT $1,000,000 ELDISEASE-EAEMPLOVEE $1,DDD,DDD (Mandatory in NH) If DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,DDD DD0 D E&O - Primary $5M 08225699 /31/2012 07/31/2011 $5M Occ/$5M Agg E E&O - $5M XS $5M NY12MPL0007121C F/31/2012 07131/201 Ii $5M Excess DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 10T Additional Remarks Schedule, it more space Is required) Certificate holder is named as additional insured under the automobile liability and general liability for work performed by the insured, only as required by written contract. City of Fort Collins P.O. Box 580 Fort Collins, CO 80522.0000 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 M @ 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 #S1178175/M1178099 The ACORD name and logo are registered marks of ACORD KS5 Client#: 67967 CCMSHOI ACORD.. CERTIFICATE OF LIABILITY INSURANCE Do D71 (31 /21011Y2YYY) 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 CONTACT Leah Cozad NAME: Mackey Team PHONE, 312 595.7142 FAX , AIC, NoElf: AICNo 312 595-7163 Mesirow Insurance Services ADDRESS: Icozad@mesirowfinancial.com 353 N. Clark Street Suite 1200 INSURERISI AFFORDING COVERAGE NAIC# Chicago, IL 60654 INSURERA: Charter Oak Fire Insurance Comp 25615 INSURED INSURER B: Travelers Property Casualty Co. 25674 CCMSI Holdings, Inc Travelers Indemnity Co. of Amer INSURER C : Y 25666 2 East Main Street, Suite 208 INSURER D: Federal Insurance Company 20281 Towne Centre Building INSURER E:P Y Navigators S Specialty Insurance 36056 Danville, IL 61832 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 CONTRACTOR 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 ADDLSUBR INSR MD POLICY NUMBER POLICY EFF MMIDDdYYYY POLICY EXP MMIDDNYYY LIMITS A GENERAL LIABILITY P6301918P719COF11 11/17/2011 11117/2012 EACH OCCURRENCE S1000000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR PAEMI3 S Ea occE ante 8100,000 MED EXP(Any one person) $5,000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY JECT X LOG $ A AUTOMOBILE LIABILITY P810191BP719COF11 1111712011 11/17/201 Eoael dECSINGLE LIMIT en 1 $1,000,000 BODILY INJURY (Per person) $ X ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS INJURY (Per acci BODILY dent) $ NON -OWNED X HIRED AUTOS X AUTOS PROPERTY DAMAGE Paraccident $ 3 B X UMBRELIALIAB OCCUR PSMCUP191OP71909TI 11/17/2011 11/17/201 EACH OCCURRENCE $10000000 AGGREGATE $10 000 000 EXCESS LIAB CLAIMS -MADE DED I X RETENTION$10000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITYTORY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICERIMEMBER EXCLUDED] N/A PHUB1918P71911 11/17/2011 11117/201 ETH- X WCSTATu- 10 LIMITS E.L. EACH ACCIDENT $1000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 (Mandatory in NH) describe under DIf ESCRIPTION OF OPERATIONS below EL.DISEASE - POLICY LIMIT S1,000,000 D E&O - Primary $5M 08225699 07131/2013� $5M OCc1$SM Agg - E E&O - $5M XS $5M NY12MPL0007121C F/3113112012 /2012 07/31/20131 $5M Excess DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Certificate holder is named as additional insured under the automobile liability and general liability for work performed by the insured, only as required by written contract. City of Fort Collins P.O. Box 580 Fort Collins, CO 80522.0000 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 9 @ 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 #S1178175/M1178099 The ACORD name and logo are registered marks of ACORD KS5