HomeMy WebLinkAboutHSS INC - INSURANCE CERTIFICATEP]111II.U2
® CERTIFICATE OF LIABILITY INSURANCE DATE20/2 n2
ACORO Also/zo12
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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 1-303-773-9999 CONTACT Lori Smith
NAME:
Arthur J. Gallagher Risk Management services, Inc. PHONE FA%
_ �-.. (303I 889-2608 u..r(303) 889-2609
6399 S. Fiddlers Green Cir
ADDRESS:
loriann—serithcaajg. corn
INSURERIS) AFFORDING COVERAGE
NAICN
Suite 200
Greenwood Village, CO 80111
INSURERA:
ARCH INS CO
11150
INSURED
INSURERS:
PHIDADELPHIA IND INS CO
18058
LESS Inc.
INSURER L:
ZURICH AMER INS CO
16535
INSURERD:
900 S Broadway
INSURER E:
Denver, CO 80202
INSURER F:
r.OVFRAGFS CERTIFICATE NUMBER: 30355909
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. NOTWI H STANDING 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 TYPE OF INSURANCE AODLSUSR POLICY EFF POLICY EXP LIMITS
LTR POLICY NUMBER MMIDDIYYYY MMIDONYYY
A
GENERAL LIABILITY
BSPKGO180304
12101/1
12/01/13
EACH OCCURRENCE
$ 1,000,000
X
DAMAGE TO RENTED
100, 000
COMMERCIAL GENERAL LIABILITY
PREMISES(Ea omurrence)
$
CLAIMS MADE I X OCCUR
MED EXP(My one parson)
$ 5,000
X Deductible: $25,000
PERSONAL B ACV INJURY
$ 11000,000
GENERAL AGGREGATE
$ 5,000,000
K Professional Liability
PRODUCTS-COMPIOP AGG
$5,000,000
GEWL AGGREGATE LIMIT APPLIES PER
POLICY I X IEC LOG
$
B
AUTOMOBILE LIABILITY
PHPK946499
12101/1
12/01/13
COMBINED SINGLE LIMIT
1,000,000
(Ea a=yknll
8
X ANY AUTO
BODILY INJU RY(Per Person)
$
BODILY INJURY(Pn,re.denl)
$
ALL OWNED SCHEDULED
AUTOS AUTOS
PROPERTY DAMAGE
$
_
NON OWNED
I
HIREDAUTOSAUTOS
IPeracciden0 _
$
A
X UMBRELLA LIAB X OCCUR
BSPKG0180404
12/01/1
12/01/13
EACH OCCURRENCE
$ 11000,000
E%CESSLMB CI—AIMSS MADE
AGGREGATE
S 1,000,000
DED X RETENTION$ 10, coo
$
C
WORKERS COMPENSATION
WC9827669-01 (ADS)
12/01/1
12/01/13
X WCSTATU- OTH-
T Y IMIT R
AND EMPLOYERS' LIABILITY YIN
EL EACH ACCIDENT
$ 1,000,000
C
ANY PROPRIETORIPARTNERF ECUTIVE❑
WC9827668-01 (WI)
12/Ol/1
12/Ol/13
OFFICERMEMDER EXCLUDED? NIA
(Mandatary in NH)
E.L. DISEASE - EA EMPLOYEE
$1,000,000
N Yee. eNvnha Under
DESCRIPTION OF OPERATIONS habw
EL DISEASEPOLICYLIMIT
S1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (AIMch ACORD 101, Adddional Ramarhs SchadulR, it moro space is requinrd)
For Bid: 7100 Security Services - City of Fort Collins Police Services Building
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
For Bid Only - City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
215 North Mason Street
AUTHORIZED REPRESENTATIVE
2nd Floor ,/'�'� /'�
Ft. Collins, CO 80522 G?4t XX -
I USA O � V�*�
01988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
deeDaden
30355909