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HomeMy WebLinkAbout462625 PEAK LEADERSHIP CONSULTING - INSURANCE CERTIFICATE (3)173147 ® CERTIFICATE OF LIABILITY INSURANCE ,4� o OAT/D0/YYYY) 5115 5/15/2013 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 Commercial Lines - (330) 726-8861 CONTACT Linda McLaughlin NAME: 9 PHONE 330-729-2632 FAX 877-850-6512 .(A/C, No, Exit; (A/C, No): EMAIL o.coml d na.mcau hlin wellsfar ADDRESS: Li9 @ 9 Wells Fargo Insurance Services USA, Inc. INSURER($) AFFORDING COVERAGE NAIC it 8561 Market Street II i Youngstown, OH 44512-6727 lY •�")/L INSURER A: American Casualty Company of Reading, PA 20427 INSURED INSURER B: Hartford Accident and Indemnity Company 22357 Peak Leadership Consulting INSURER C D 4548 Seaway Circle _INSURER INSURER E: _ INSURER F Fort Collins, CO 80525 COVERAGES CERTIFICATE NUMBER: 6047993 REVISION NUMBER: See below 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. INSRPO ICY OFF POLICY EXP LTR TYPE OF INSURANCE INSRAOOLISUMe Bk POLICY NUMBER MMIDDIYYYY) (MM1DDlYYYYT LIMITS A GO N ERALLIABILfTY GENERAL LIABILITY X 4030752651 0611 OI2013 06/10/2014 EACH OCCURRENCE -DAMAGE To RENTEb -PREMISES (Eaoccuvencel $ 1,000,000 _$ 300.000 tXCOMMERCIAL CLAIMS -MADE IT]OCCUR MED EXP (Any one person) $ 10,000 PERSONAL& AOV INJURY $ 1,000,000 _ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG IS 2.000,000 X POLICY n PRO- n LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (E accident) 1,000,000 _a BODILY NJURY(Pc, pesu,) _$ If ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS _ BODILY INJURY (Peraccidenl) $ PROPERTY DAMAGE (per accident $ A X NON -OWNED HIREDAUTOS X AUTOS X 4030752651 06/10/2013 06/10/2014 E UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED RETENTIONS $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE❑ 45WECVY2321 06/01/2013 06/0112014 X WC STATU- OTH- T4RY-t_IMITS --ER_ E.L. EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? (Mandatory inNH) NIA E.L. DISEASE - EA EMPLOYE - -- S W0,000 DESCR PTION OF OPERATIONS helow E.L. DISEASE -POLICY LIMIT $ 1G0.000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) S13-146932-D (Ed. 07/09) City of Fort Collins is Additional Insured. Reference form SB300120B 0410. J"1191 l4 al W-11111-1 CI City of Fort Collins I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn: Purchasing THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE rn' 1✓_ _ The ACORD name and 19 logo are registered marks of ACORD © 88-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) 1111111111111111111111111111111111111111111111111111 1111111111111111111111111111 'CYBOtAt51W 1]]6N]ALOI6TN'