HomeMy WebLinkAbout128365 NATIONAL RESEARCH CENTER INC - INSURANCE CERTIFICATE (6)NAT1430 OP ID: MCI
,�+coRO CERTIFICATE OF LIABILITY INSURANCE
DATE 212013YI
01102I2013
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 endorsements . - - - -
PRODUCER Phone:303-781-6776
NEISEN BORTH AGENCY -
www.nbinsure.com Fax: 303.789-4409
CONTACT
NAME - "-
(A///co, No,,E.O;
E-MAIL
ADDRESS:
333 W. Hampden Ave. Ste. 410
Englewood, CO 80110
Neisen Insurance, Inc. i •� Q� I„ �
INSURER(S) AFFORDING COVERAGE
I N
INSURER A: Philadelphia Insurance Company
INSURED National Research Center, Inc.
2955 Valmont Road Ste 300
INSURER B:
Boulder, CO80301 ';
INSURERC:
INSURER D
INSURER E :
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 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 ODL UBR POLICY EFF POLICY EXP
LIP TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS
GENERAL LIABILITY -
EACH OCCURRENCE
$
-DAMAGE 70 RENTED
COMMERCIAL GENERAL LIABILITY
PREMISES Ea occurrence
$
CLAIMS -MADE 11 OCCUR
MED EXP(Any one Person)
$
PERSONAL B ADV INJURY
$
GENERAL AGGREGATE
5
-
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
5'
POLICY ' PRO ,` n Lam.,
AUTOMOBILE
LIABILITY -O
-
COMBINED SINGLE LIMIT
Ea accident
5
BODILY INJURY (Per person)
$
ANY AUTO
I
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
HIRED AUTOS AUTOS
A
'1'
ri
'
BODILY INJURY (Per acu0ent)
$
PROPERTY DAMAGE
Per accident
$
$
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAR
CLAIMS -MADE
DED I I RETENTION$
$
WORKERS COMPENSATION
VvC STATU- OTH-
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNER/EXECUTIVE❑
OFFICER/MEMBER EXCLUOEDP
NIA
TORY LIMITS ER
E.L. EACH ACCIDENT
5
E.L-DISRASE-EA EMPLOYE
$
(Myandatory In NH)If
DE esSCRIPTION OF OPERATIONS below
EL.DISEASE -POLICY LIMIT
$
A
Professional I
PHSD792107
01/01/2013
01/0112014
Prof Liab _ 2,000,000
A
Cyber Security Lia
PHSD807572
01/01/2013
01101/2014
Cyber Lia 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if mom space Is required)
The Professional Liability policy includes Errors S Omissions Coverage of
$2,000,000 each claim,$2,000,000 annual aggregate, $5,000 .deductible.
CITYFTC
City of Fort Collins
City Hall West
300 Laporte Avenue
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
�
daRR-inin Art -non rnGonGATInId All •inh.n --A
ACORD 25 (2010/06) The ACORD name and logo are registered marks of ACORD