HomeMy WebLinkAbout507508 US SECURITY ASSOCIATES INC - INSURANCE CERTIFICATE (2)CERTIFICATE OF LIABILITY INSURANCE
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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 endomement(s).
PRODUCER
Aon Risk Services South, Inc.
Atlanta GA Office
CONTACT
NAME:
INC. No. Eet); NE (866) 283-A22 FNC Ne ; (800) 363-0105
EMAIL
ADDRESS:
3565 Piedmont Rd NE,B191,#700
Atlanta GA 30305 USA
INSURERIS) AFFORDING COVERAGE
NAIC#
INSURER A: Liberty Mutual Fire Ins Co
23035
tV Associates. Inc.
Court EastINSURER
E
INSURER B: Lexington Insurance Company
19437
CNdtlOndl DniDn Fire Ins CO of Pittsburgh
19445
0076 USA
INSURER D: Liberty Insurance Corporation
42404
INSURER E:
INSURER F:
UuVtKAueb Uell I If ILIA It NUMIStK: O/0004/OUSUU KGVISIUN NUNIL3tK:
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. Limits shown are as requested
INSR T
TYPE OF INSURANCE
INSD
WID
POLICY NUMBER
MWDDWYYY
MMID
LIMITS
B
X
COMMERCIAL GENERAL LIABUTY
EACH OCCURRENCE
E1, 000,000
CLAIMS -MADE %❑ OCCUR
SIR applies per policy terns
& condl
ions
PREMISES Eaoccunence
$500,006
X
MED EAR (Anyone person)
S5,000
Per Loca(ron Aggregate limd
aubjedtoovers11$25MGenem1Agg.
PERSONAL& ADV INJURY
S1,000,000
GENT AGGREGATE LIMIT APPLIES PER.
GENERAL AGGREGATE
S2,000,000
POLICY ❑ PRO JECT �X LOG
PRODUCTS - COMP/OP AGO
Included
OTHER:
Pmtessianal Liability
Included
A
AUTOMOBILE LIABILITY
AS2-641-443931-054
08/01/2014
08/01/2015
COMBINED SINGLE LIMB
(Ea,rodent
E1, 000, 000
BODILY (MURY (Per person)
X ANY AUTO
BODILY INJURY (Per acciden0
X ALL OWNED SCHEDULED
AUTOS AUTOS
X HIREDAUTOS X NON -OWNED
AUTOS
PROPERTY DAMAGE
Per enadent
C
X
UMBRELLA LIAR
X
OCCUR
BE19961597
08/01/2014
08/01/2015
EACH OCCURRENCE
E5,000,000
EXCESS LIAB
CLAIMSMADE
AGGREGATE
$S, ODD, OOO
DED I X
RETENTION f35, 000
D
D
WORKERS COMPENSATION AND
EMPLOYERS'LWBILRY YIN
TI
ANYPROPRIETORIPARTNERIEXECUVE
OFFICENMEMBER EXCLUDED?
(Mandatory in Mo
NIA
WA764D443931014
ADS
WC7641443931044
WI
08/01/2014
OS/01/2014
08/01/2015
DB/Ol/201$
X PER OTH-
STATUTE ER
EL. EACH ACCIDENT
$1,000,OOD
E.L. DISEASE -EA EMPLOYEE
S1,000,000
Ny doembe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE -POLICY LIMIT
E1,000,000
B
Excess Auto Lid
048409879
08/01/2014
08/01/2015
Each Occurrence
$4,000,000
DESCRIPTION OF OPERATIONS I LOCAMNS I VEHICLES (ACORD 101. Additional Renarks ScMdv4, may W atScMd a mom epce Is m,Wmd)
Certificate Holder is included as Additional Insured in accordance with the policy provisions of the General Liability
policy.
CERTIFICATE HOLDER
CANCELLATION
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
Purchasing Department
AUTHORIZED REPRESENTATIVE
P.O. BOX Z80
Ft. Collins CO 80522 USA
ACORD 25 (2014101)
01988-2014 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
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