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HomeMy WebLinkAbout516354 THE OMEGA GROUP - INSURANCE CERTIFICATE (2)THEOM-1 OP ID: SW ,A`c✓o�zo CERTIFICATE OF LIABILITY INSURANCE DATo9/11OIYYYY) F09/11/13 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 619-238-1828 Alllant Insurance Services Inc 619-849.4731 CA License - OC36861 701 B Street, 6th Floor San Diego, CA 92101 5135-Select Business Solutions NOW AMEACT SIBS Department PHONE 619-238-1828 FAX Nq..: lac No : 619-849-4731 E-MAIL sbs@alliantinsurance.com ADDRESS: INSURER( AFFORDING COVERAGE NAIL 11 INSURER A Federal Insurance Company INSURED The Omega Group Inc INSURER B: Travelers Property Casualty 25674 Stephanie Fimbres 5160 Carroll Canyon Rd 1St Fl. INSURER C: INSURER D San Diego, CA 92121-1775 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. NSR R TYPE OF INSURANCE L IN SUB POLICY NUMBER EFF MMIDDPOLICYIYYYY L ICY EXP MMDDNYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERALLIABILITY 35797495WCE 00/27/13 08/27114 _DAA PREMISES ffa ocTE PREMISES ERSNTrrence S 1,000,000 CLAIMI a OCCUR MED EXP(Any one Person) S 10,00 PERSONAL B ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEHL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2,000,000 $ POLICY 7PRO LOC LIABILITY EOeBBIIlEeDtSINGLE LIMIT S 1,000,000 BODILY INJURY(Per person) S AANYAUTO 74991759 08127113 08127114 POMOBILE ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS J( NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTYOAMAGE Per amident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE S 2,000,000 A ( EXCESS LIAB CLAIMS -MADE 79822226 08127/13 08/27/14 OEO I X I RETENTIONS $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR,PARTNERIEXECUTIVEYIN UB3539X975 01128113 01128114 X WC STATU- OTH- TORY LIMIT ER E.L.EACHACCIDERT $ 1,000,000 OFFICERIMEMBER EXCLUDED? ❑ (Mandatory in NH) NIA E.L. DISEASE -EA EMPLOYE $ 1,000,000 If yes, tlescdbe antler D. RIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Info 8, Tech E80 35797495WCE 08/27/13 08/27/14 Aggregate 2,000,00 Retro Date 08/2712002 Ded 25,0010 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) RE: GIB MAPPING. The City of Fort Collins, its officers, agents and employees, The Poudre Fire Authority are named Additional Insured. City of Fort Collins PO Box 580 215 N Mason 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 =/-rJ [.../Arl/ ©1988-2010 ACORD CORPORATION. All rights reserved ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD THEOM-1 OP ID: SW ,AAcoRo CERTIFICATE OF LIABILITY INSURANCE OAT09/11OIYYYY) 9111113 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 619-238-1828 Alliant Insurance Services Inc 619-849.4731 CA License - OC36861 CONTACT NAME: SBS Department PHONE .619-238-1828 F"'I 619-849-4731 C-Nd- aC Nol: M E-IL sbs@alliantinsurance.com ADDFEE, A 701 B Street, I Floor San Diego, CA 92101 5135-Select Business Solutions INSURER(S) AFFORDING COVERAGE NAIL R INSURER A; Federal Insurance Company INSURED The Omega Group Inc INSURER B: Travelers Property Casualty 25674 Stephanie Fimbres 5160 Carroll Canyon Rd 1St F1. INSURER C: INSURER D: San Diego, CA 92121-1775 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 ADDTYPE OF INSURANCE INSR SUB POLICY NUMBER MMDDYfYYYY MM DDNEFF POLICY 9 LIP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY X 35797495WCE 08127/13 08/27/14 PREMISES Ea occurrence $ 1,000,000 CLAIMS -MADE T OCCUR MED EXP(Any one pemon) S 10,00 PERSONAL&ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG S 2,000,000 POLICY PRO LOC F E AUTOMOBILE LIABILITY D S INGLE LI MIT er'A 1,000,000 NJ URY IF., person) $ ANY AUTO 74991759 08/27113 08/27114 ALL OWNED SCHEDULED AUTOS AUTOSHIRED NJURY(P'acident) rE $ AUTOS X NON -OWNED AUTOS TY OHMAG$ ent E X UMBRELLA LIAR X OCCUR EACH OCCURRENCE E 2,000,000 AGGREGATE $ 2,000,000 A EXCESS LIAB CLAIMS -MADE 79822226 08/27/13 08/27114 DED I X I RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORJPARTNEWEXECUTIVE YIN X U63539X975 01128113 01128N4 X WC STATU OTH- T RV LIMITS R EL EACH ACCIDENT S 1,000,000 OFFICEWMEMBER EXCLUDED? ❑ (Mandatory In NH) NIA EL DISEASE - EA EMPLOYE $ 1,000,000 If yes, tlescno under DESC RIPTION OF OPERATIONS OeIpw E.L. DISEASE -POLICY LIMIT $ 1,000,000 A Info & Tech E&O 35797495WCE 08127113 08/27/14 Aggregate 2,000,00 Retro Date 0812712002 Ded 25,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is red ulred) FORTCOL City of Fort Collins Attn: Ed Bonnette, Purchasing P.O. Box 580. 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. n 1QRR-7n1n Arr1Rn r0F?PrTRATInN All rir hft r..—A ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD