HomeMy WebLinkAbout288418 COMVERGE INC - INSURANCE CERTIFICATE (5)Acbmo® CERTIFICATE OF LIABILITY INSURANCE
DA5/19/2014
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
Commercial Lines - (813) 639-3000
Wells Fargo Insurance Services USA, Inc.:
2502 N. Rocky Point Drive, Suite 400
Tampa, FL 33607
NAME CT Kris Thompson
PHONE . 813-639-3058 FAx 813-639-7196
LA'CNo AC No:
ADDRESS: kris.thompson@wellsfargo.com
INSURER ($) AFFORDING COVERAGE
NAIL r
INSURERA: Liberty Mutual Fire Insurance Cc
23035
INSURED
Comverge, Inc.
5390 Triangle Parkway
INSURER B: Liberty Insurance Corporation
42404
INSURER c: First Liberty Insurance Corporation
33588
INSURER D: Lexington Insurance Company
19437
INSURER E: Indian Harbor Insurance Company
36940
Norcross, GA 30092
-
INSURER F
COVERAGES CERTIFICATE NUMBER: 7737403 REVISION NUMBER: See below
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
ADDL
J=
SUBR
MD
POLICY NUMBER
POLICY EFF
MM/OD
POLICY UP
MM/DD
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS�MADE rX1 OCCUR
TB2Z91462186014
2/28Y2014
2/2$/2015
EACH OCCURRENCE
E 1,000,000
DAMAGE TO RENTED1,000,000
PREMISES Ea occurrence
E
X
MED EXP (Any one person)
$ 10,D00
PD DED 10,000
Primary & Non -Contributory
PERSONAL BADV INJURY
$ 1,000,000
X
GENT
AGGREGATE LIMIT APPLIES PER:
POLICY JECT LOC
GENERALAGGREGATE
$ 2.000,000
PRODUCTS - COMP/OP AGG
E 2,000.000
$
OTHER
A
AUTOMOBILE
LIABILITY
A82Z91462186014
2/28/2014
2/28/2015
COMBINED SINGLE LIMIT
Ea accident
$ 1.000.000
X
BODILY INJURY (Per person)
$
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY Perawitlem
( )
$
X
X NON-O MED
HIRED AUTOS AUTOS
PROPERTY DAMAGE
JPer accident
$
E
B
%
UMBRELLA LIAB
X
OCCUR
TH7Z91462186064
2/28/2014
2/28/2015
EACH OCCURRENCE
$ 20,000,000
AGGREGATE
E 20.000,000
EXCESSLIAB
CLAIMS -MADE
DEC, X RETENTION$ 10,000
$
C
AND EMPLOYERS' LIABILITY �,/N RKERS COMPENSATION
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED' ❑N
N/A
WC6Z91462186044
2/28/2014
2/28/2015
X PER TH-
STATUTE ER
E.L. EACH ACCIDENT
1,000,000
E
E.L. DISEASE - EA EMPLOYEE
$- 1.000.000
_
(Mandatory in NH)
Kies, descnbe under
DESCRIPTION OF OPERATIONSbelcw
-
- .-
E.L. DISEASE - POLICY LIMIT
E 1,000,000
D
Professional Liability
(Architects & Engineers
026154190
05/15/2014
05/15/2015
$2,000,000 Each Claim
$3,000,000 Aggregate
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional RemarksSchedule, may be attached tt mom apace la required)
The City of Fort Collins, its officers, agents and employees shall be named as additional insureds as it relates to general and auto liability in accordance
with the terms and conditions of the policies. 30 day notice of cancellation except for non payment of 10 days.
City of Fort Collins
City Clerk
PO Box 580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Fort Collins, CO 80522 AUTHORIZED REPRE5ENTAME
9/._
I
The ACORD name and logo are registered marks of ACORD 01988-2014 ACORD CORPORATION. All riahts
ACORD 25 (2014/01)
CID:207326 SID:7737403 .
Certificate of Insurance (Con't)
OTHER Coverage
INSR TYPE OF INSURANCE ADDL WVD POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE LIMIT
LTR INSR SUBR (MM/DD/YY) (MM/DD/YY)
E Errors & Omissions MTP0040592 05/15/2014 05/15/2015 $2,000,000 Each Occurrence
$2,000,000 Aggregate
Certificate of Insurance-Con't