HomeMy WebLinkAboutAEROTEK INC - INSURANCE CERTIFICATE. lk. R CERTIFICATE OF LIABILITY INSURANCE
`/
DATE(9/2012
11/19/2012
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 Xrista Dean
NAME:
_
ac°No E.01 (610) 526-9130 1FAA/C.No: (610)526-2021
Altus Partners, Inc
919 Conestoga Road
ADonless:certificates®altuspartners. com
PRODUCER 00000023
-CUSTOMER
Building3, Suite 111
INSURER(S) AFFORDING COVERAGE
NAICp
Rosemont PA 19010
INSURED
INSURERA:ACE American Insurance Co.
122667
INSURER B:ACE American Insurance Co.
122667
Aerotek, Inc.
INSURER c:ACE Property & Cas Ins Co.
120699
7301 Parkway Drive
INSURER D:Indemnity Ina Co of NA 43575
Hanover MD 21076
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 12-13 Standard 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
LT
TYPE OF INSURANCE
ADDL
SUER
POLICY NUMBER
MM DD/YYYY
MM% � /YYYY
LIMITS
A
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
X $lmm SIR
G27015074
11/30/2012
11/30/2111
EACH OCCURRENCE
$ 1,000,000
MAGEX
PREMSES DEaoccurRENTEence
$ 1,000,000
MED EXP(Any one person)
$ 10,000
PERSONAL B ADV INJURY
$ 1,000, 000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY PRO- n LOC
PRODUCTS-COMP/OPAGG
$ 2,000,000
S
B
B
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON OWNED AUTOS
B08711975
H08711987 (Owned)
41/30/2012
11/30/2013
COMBINED SINGLE LIMIT
(Ea decidenq
S 1,00 0, 000
BODILY INJURY (Per poised)
$
X
BODILY INJURY (Per accident)$
PROPERTY DAMAGE
(Per accident)
$
X
X
$
3
C
X
UMBRELLA LIAR
EXCESS LIAB
X
OCCUR
CLAIMS MADE
G27049187
11/30/201211/30/2013
EACH OCCURRENCE
S 5,000,000
AGGREGATE
$ 5,000,000
DEDUCTIBLE
RETENTION S 100,000
$
X
$
D
WORKERS COMF[!::3ATIOR
AND EMPLOYI,m ' LIABILITYYIN
ANY PROPRIETORIPARTNER/EXECUTIVE
OFFICERIMEMBER E%QUDEO? N
(Mandatory in NH)
It yyerib s, desce under
DESCRIPTION OF OPERATIONS below
N / A
C47127993
!11/30/201211/30/2013
Y TWO STATU- UTH-
ORYLI
-
E.L. EACH ACCIDENT
$ 1, 000, 000
E.L. DISEASE EA EMPLOYEE
S 1,000,000
E.L. DISEASE -POLICY LIMIT IS
1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required)
Certificate issued as evidence of insurance per policy terms,conditions and exclusions. Certificate holder is an
additional insured on the general liability insurance policy per the written agreement and on the automobile liability
insurance policy per the policy terms, conditions and exclusions.
City of Fort Collins
Attn: Purchasing Division
215 N. Mason Street, 2nd Floor
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-
sta Dean/XMD Gr�o?-
ACORD 25 (2009/09) O 1988-2009 ACORD CORPORATION. All rights reserved.
I NS025 (200909) The ACORD name and logo are registered marks of ACORD