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Home My WebLink About406748 MCMS INC - INSURANCE CERTIFICATE (2)ACORD CERTIFICATE OF LIABILITY INSURANCE iM O06/20ATS/p2/201313 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 NAME: Karole Peters Ewing -Leavitt Insurance Agency 4025 St. Cloud Dr. PHONE E,t:970.679.7355 FAX n ORess: karole-peters@leavitt.com Suite 100 INSURERS) AFFORDING COVERAGE NAIC N Loveland, CO 80538 ) INSURER A: Cincinnati Insurance Co 10677 INSURED MCMS, Inc. INSURER : Pinnacol Assurance 41190 136 Bothun Rd INSURER C: Berthoud, CO 80513 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 13-14 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 CONTRACTOR 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. R LTR TYPE OF INSURANCE OgSUBR INSR WVD POLICY NUMBER MMIDD/YYYY OLfCV MM/DD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR X Blkt Addl Insured EPP014695506125/2013 06/2512014 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence) $ 500,000 MED EXP(Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 X Blkt Waiver of Sub GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO- n LOC ECT PRODUCTS - COMPIOP AGG $ 2,000,00 $ A AUTOMOBILE LIABILITY ANYAUTO AOSCHEDULED AUTOS AUTOS HIREDAUTOS X NON -OWNED AUTOS EPP0146955 06125/2013 06/2512014 Ea accitlent $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X (Per accident) $ A )( UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE EPP0146911 06/2112/13 06125/2014 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,00 DED I X I RETENTION$ C $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOWPARTNEWEXECUTIV OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If YYes, describe under DESCRIPTION OF OPERATIONS below N / A 4089148 02101/2013 02/0112014 X I ATU- - TORY LIMITS ER E. L. EACH ACCIDENT $ 500,000 E.L. DISEASE- EA EMPLOYEE $ 500, 00 E.L. DISEASE - POLICY LIMIT - $ 500.00C A Leased and Rented Equipment EPP014695506125/2013 06/2512014 $200,000 Limit $5,000 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101. Additional Remarks Schedule, If more space is required) FAX: 970.221.6379 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins AUTHORIZED REPRESENTATIVE PO Box 580 Fort Collins, CO 80522 Karnla pcstnrc/leap{ L ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD reserved.