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Home My WebLink About520431 SCHEIDT & BACHMANN USA INC - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE DATE(111MOIYYYY) O,I122016 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(les) 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 endorsemerd(s). PRODUCER Ann Risk Services Northeast, Inc. Boston MA office ACT COW NAME: PI -IONS (866) 283-7122 F'ix 800-363-0105 INC. No. Ut): ac. NP.: One Federal Street Boston MA 02110 USA E ML ADDRESS: INSURERS) AFFORDING COVERAGE MNC0 INSURED INSURERA, Travelers Casualty&Surety. CO of America 31194 Scheidt & Bachmann USA Inc INSURER B: The Phoenix Insurance Company 25623 31 North Avenue Burlington MA 01803 USA INSURER C: The Travelers Indemnity Co of America 25666 INSURER!: XL Insurance America Inc 24554 WSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570056590784 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. Limits shown am as requested LTR TYPE OF INSURANCE INS! VND POLICY NUMBER D LIMITS D X COMMERCIALGENERALLIABILITY US LI A EACH OCCURRENCE S1,000,000 CLAIMS -MADE R❑OCCUR PREMISES (Ea ooznence S100,000 HIED UP (My one Pelson) S10, 000 PERSONAL &ADV INJURY $1,000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE S2,000,000 X POLICY P' �LOC PRODUCTS-COMIPIOPAGG $2,000.000 OTHER: EnP Bermfde Per Clam S1,000,000 B AUTOMOBILE LIABILITY Y 810 9199C532-15 01/01/201501/01/2016 COMBINED SINGLE LIMIT S500,000 ADS BODILY INJURY I Per person) X ANY AUTO BODILY INJURY(Perac en0 ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PRr=DAMAGE Porecddenl z CanP Ded r1,Do0 X cduwn Om s,,DOD UMBRELLA LJAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MWDE AGGREGATE DIED RETENTION C WORKERS COMPENSATION AND EMPLOYERS'LJABILRY YIN ANY PROPRIETOR I PARTNER I EXEOJnVE OFFICEWMEMBERFJICLUDED? F9 (Mandatary in NM NIA YUB8427C67615 151 01 2015 01 01 2016 PER DTH- X STATUTE E.L. EACH ACCIDENT S100,000 E.L. DISEASE -EA EMPLOYEE S100,000 It ye daeome anger DESCRIPTION OF OPERATIONS!x,P E. L. DISEASE -POLICY LIMIT S500,000 A D&O-Primary - 105721510 12/20/2014 12/20/2015 Each LOSS Limit $2,000,000 SIR applies per policy ter is & condi ions Retention $15,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, AddlUonel Ren,nb Schedule, may he amched it more apece Is required) City of Fort Collins is included as additional with respect to the general liability policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUNERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of Fort Collins 215 North Mason Street, 2nd Floor Fort Collins CO 80524 USA Of 988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD s AGENCY CUSTOMER ID: 10603646 LOC #: " ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Services Northeast, Inc. NAMEDINSURED Scheidt & Bachmann USA Inc POLICY NUMBER See Certificate Number: 570056590784 CARRIER See certificate Number: 570056590784 NAIC CODE 1EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. L\SR LTR TITEOFENSURANCE ADDL INSD SUBR HID POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/I1'VY POLICY E%PIRAT10% DATE MM1DDnIT LIMITS GENERAL LIABILITY D US0001004SLIJSA 01 01/2015 01/01/2016 . Emp Benefits Aggregate S1,000,000 Emp Benefits Deduct. S15,000 ACORD 101 (2008101) m 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD