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Home My WebLink About445046 PATTON BOGGS LLP - INSURANCE CERTIFICATE (4)CERTIFICATE OF LIABILITY INSURANCE DATE(MMOD7Y , Brovzalz 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(les) 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: AOn Risk Services Northeast, Inc. New York NY Office PHONE (866) 293-712Z FAX (847) 953-5390 WC. No. EXI: NO. N..: E4AL ADDRESS: 199 Water Street New York NY 10038-3551 USA INSURER(S) AFFORDING COVERAGE NAIC4 I SO'(� W5URE0 INSURER A: Great Northern Insurance CO. 20303 PdLLOn R0995 LLP 2550 M Street, N.W. INSURER B: Federal Insurance Company 20281 INSURER C: WdShl ngCOn DC 20037-1350 USA INSURER 0: WSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570047754010 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. Limits shown are as requested LTR TYPE OF INSURANCE INSR VIVID POLICY NUMBER MMmO MMm UNITS B GENERAL 11NBERY3S764614 EACH OCCURRENCE $1,000,000 COMMEROULGENERALUAEaUTY Package Policy PREMISES aCLAMS-MADEOCCUR $1,000,000 MED EXP(Any one person) $10,000 PmdL mmCp Intl in Gent Ago I PERSONAL 6 ACV INJURY $1,DDO,DDe GENERAL AGGREGATE S2,000,000 GEN'L AGGREGQE LIMIT APPLIES PER. PRODUCTS- COMPIOP AGO X POLICY PH_ LOC B AUTOMOBILE LIABILITY 74986701 Automobile Policy 10 01 201210 01 2013 COMBINED SINGLE LIMIT Me acoa nt $1,000,00C BODILY INJURY ( Per person) % ANY AUTO BODILY INJURY (Per soarers) ALLOWNED SCHEDUlEO AUTOS AMOS X HIREDAUTOS X NON.OWNED AUTOSaccident) PROPERTY DAMAGE 0 X UMBRELLALIBB X OCCUR 93630074 101011ZD12 10/01/2013 EACH OCCURRENCE $5,000,000' EXCESS LIAR CLAIMS-MADE Umbrella Policy AGGREGATE $5,000,000 DED I RETENTION A WORRERSCOMPENSATIONAND EMPLOYERS -LIABILITY YIN ANY PROPRIETOR I PARTNER I EXECUTIVE ❑ OrnCFILNENBEA FaCLUDEDT N/A 71721244 Workers' Compensation Pal 0 01 2012 05 01 2013 - X WC STATLL OlK TORY LIMITS ER E L. E>CH ACCIDENT $11000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 (Nyamuch, m Nlq DIfiESCRIPTION OF OTPERATIONS below E.L OISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS; VEHICLES (Mach ACORD 101, Memorial Remarks Schedule, If more space Is required) Evidence of insurance coverage in force. I I CERTIFICATE HOLDER CANCELLATION S SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. The City Of Fort Collins, Colorado, AUTHORMED REPRESENTATIVE A Municipal Corporation P.O. Box 580 Fort Collins co 80522 USA �pn `01�988-200110 ACORD cCORPORATION. JAll rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD `m