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HomeMy WebLinkAbout144217 CCMSI HOLDINGS INC - INSURANCE CERTIFICATE (4)Client#: 67967 CCMSHOL ACORD.,, CERTIFICATE OF LIABILITY INSURANCE O11/152013 11/15/2013 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). If Waiver of Subrogation Is applicable, It only applies to the extent allowed by law. PRODUCER NCONTACT ONE: Leah Cozad Mackey Team PNONNEq .312595-7142 AIC No Mesirow Insurance Services EaaAIL 353 N. Clark Street ADDRESS: INSURER(SAFFORDING COVERAGE NAIcw Chicago, IL 60654 INSURER A: Charter Oak Fire Insurance Comp 25615 INSURED CCMSI Holdings, Inc INSURERB: Travelers Property Casualty Co. 25674 INSURER c: Phoenix Insurance Company 25623 2 East Main Street, Suite 208 INSURER D: Federal Insurance Company 20281 Towne Centre Building Danville, IL 61832 INSURERE: Navigators Insurance Company 42307 COVERAGES CERTIFICATE NNMRFR- ocvlclnM hlnuoco 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. LTRR TYPE OF INSURANCE A SRL WO POLICY NUMBER MMIOOV EFF IC YYYY MWOLDoE LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL UABILRY CLAIMS -MADE 4OCCUR P6301918P719COF13 11117/2013 11/171201A EEpAApCC�HHp $1 OOO OOO �OEECCCTURRREENCE PPEMISES EarOra,ca $1 gg ggg MED EXP (My one parson) $5000 PERSONAL 8 ADV INJURY $1 OOO 000 GENERAL AGGREGATE s2,000 OOO_ GENT AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC JECTA PRODUCTS-COMP/OPAGG s2,000000 $ AUTOMOBILE LU1aILrrY ANYAUTO ALL OWNEDSCHEDULED AUTOS AUTOS HIRED AUTOS XN�SWNED AO P8101918P719COF13 11/17/2013 11/17/2014 COMBINEDIWIN ELIMIT 1,000,000 R BODILY INJURY (Par peen) $ BODILY INJURY (Par accident) $ PROPERTY DAMAGE ER s S B �( UMBRELUA EXCESS UAS X OCCUR CLAIMS -MADE CUP191SP719TIL13 1117/2013 1111712014 EACH OCCURRENCE $10 000 000 AGGREGATE $1000O 000 DEC) I X RETENTIONs10000 $ C WORKERSCOMPENSAT10N AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? � (Mandatory In NH) Use. describe under DESCRIPTION OF OPERATIONS below NIA P14US191SP71013 1117/201311/17/201 7/31/2013 7/31/2013 07/31/201 07/31/201 X WCSTATu- I I EOTH- E.L. EACH ACCIDENT E1 000 000 E.L. DISEASE - EA EMPLOYEE E1 60 000 E.L. DISEASE -POLICY LIMB $1000000 _ $5M Occ/$5M Agg 9511111 Excess D E E&O-Primary $5M E&O-$5M XS $5M _ 62257026 CE13MPL0007121C DESCRIPTION OF OPERATIONS / LOCATIONS / 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 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O. Box 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522-0000 AUTHORIZED REPRESENTATIVE Q ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) 1 Of 1 The ACORD name and logo are registered marks of ACORD #S1448804/M1448758 LZC