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HomeMy WebLinkAbout106536 MILLIMAN INC - INSURANCE CERTIFICATE (3)A D® CERTIFICATE OF LIABILITY INSURANCE DATEO62/2/205/2013 YI 13 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: PNONE 425-709-3600 FAX 425-709-7460 ND E*" Alc No -E^WAIL Parker, Smith & Feek, Inc. 2233 112th Avenue NE Bellevue, WA 98004 ADDRESS: INSURERS AFFORDING COVERAGE NAIC 0 ^ 1 INSURERA: Federal Insurance Company 1/•{Vs C kU INSURED 1301 an, Inc. 301 Fifth Ave., Suite 3800 INSURER B' Great Northern Insurance CO. INSURER c : Pacific Indemnity Co. INSURER D Seattle, WA 98101 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 LTR TYPE OF INSURANCE ADOL SUBR POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYYYY LIMITS A GENERAL LIABILITY 35825959 6/30/2013 6/30/2014 EACH OCCURRENCE S 1,000,000 DAMAGER D PREMISESS(Ea occurrence) 8 1,000,000 x COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F—xl OCCUR MED ESP (Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEHL AGGREG�AT'1ELIMIT APPLIES PER PRODUCTS AGO S Included RO POLICY PRO- n LOC $ B AUTOMOBILE LIABILITY 73525432 6/10/2013 6/30/2014 Ee aec a,mI)CMINED ELIMIT 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident $ NON -OWNED HIRED AUTOS AUTOS S UMBRELLA LIAB OCCUR EACH OCCURRENCE 5 AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEO I I RETENTION$ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 71719457 All States f?%CBPt WA, OF, 6/30/2013 6/30/2014 x WC STATU- OTH- TCPTNTNT ER E.L. EACH ACCIDENT $ 1,000000 OFFICERIMEMBER EXCLUDED' (Mandatory in NH) NIA ND, VVY El. DISEASE - EA EMPLOYE S 1.000,000 If es. describe under DE SCRIPTION OF OPERATIONS below EL.DISEASE - POLICY LIMIT $ 1,000.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more Space is required) Exhibit of Insurance. CITY OF FORT COLLINS AIM Jim Hume 256 West Mountain Avenue Fort Collins, CO 80522-0580 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 � ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD 2 of 2 MILLIMAN (MAK00)