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HomeMy WebLinkAbout144217 CCMSI HOLDINGS INC - INSURANCE CERTIFICATE (5)Client#: 67967 CCMSHOI ACACORD.CERTIFICATE OF LIABILITY INSURANCE DATE 7131/2/DD/YYYY) /31/2 013 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). If Waiver of Subrogation is applicable, It only applies to the extent allowed by law. PRODUCER CON A NAME: Leah Cozad Mackey Team AJCONH Est: 312 595-7142 aX, No). 312 595-7163 Mesirow Insurance Services ADDRESS: Icozad@mesirowfinancial.com 353 N. Clark Street INSURER(S)AFFORDING COVERAGE NAICd Chicago, IL 60654 �� INSURER A: Charter Oak Fire Insurance Comp 25615 INSURED INSURER B : Travelers Property Casualty Co. 25674 CCMSI Holdings, Inc INSURERC: Phoenix Insurance Company 25623 2 East Main Street, Suite 208 INSURERD: an Insurance Federal ICompany P Y 20281 Towne Centre Building INsuaeRE: Navigators Insurance Company 42307 Danville, IL 61832 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 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. INSR LTR TYPE OF INSURANCE ADDLSUBR INSR MD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR P630191BP719COF12 11117/2012 11/17/2013 EACHOCCURRENCE $1000000 PREMISES Ea oNeurD Ace $100 000 MEDEXP(Any one person) $5000 PERSONAL &ADV INJURY $1,000,000 GENERALAGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO X LOG ECT PRODUCTS - COMP/OP AGO $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS P6301918P719COF12 11/17/2012 11/17/2013 Ea BINEDISINGLE LIMIT 1,000,000 BODILY INJURY(Per person) $ IX BODILY INJURY(Per accident) $ PROPERTY DAMAGE Per accident $ $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CUP1918P719TIL12 11/1712012 11/1712013 EACH OCCURRENCE $10000000 AGGREGATE $10 00O 000 DED I X I RETENTION $10000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? � (Mandatory In NH) It yea, descrll,e under DESCRIPTION OF OPERATIONS below N/A _ PNUB191BP71912 - - 11117/2012 - 11/17/201 X WcsTATu- I JOTH- ER E.L. EACH ACCIDENT $1 OOO - -000 E.L. DISEASE - EA EMPLOYEE $1 000 000 E.L. DISEASE -POLICY LIMIT $1,000,000 D E E&O-Primary $51M E&O-$5M XS $51M 82257026 NY13MPL0007121C 7/31/2013 7/31/2013 07/311201 07/311201 $5M OCC/$51M Agg $5M Excess DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Certificate holder is named as additional insured under the automobile liability and general liability for work performed by the insured, only as required by written contract. City of Fort Collins P.O. Box 580 Fort Collins, CO 80522-0000 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 A ACORD 25 (2010/05) 1 of 1 #S1395836/M1395697 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD LZC