HomeMy WebLinkAboutSQUIRE PATTON BOGGS LLP - INSURANCE CERTIFICATE (2)AC<>RD
® CERTIFICATE OF LIABILITY INSURANCE
�,-
DnID/YYYY)
121290
2129Y2014
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
Marsh USA Inc.
216.937.1700
200 Public Square
Suite 1000
Cleveland, OH 441A
J39088-Ca 14-15
CONTACT
NAME:
PHONE FAX
IAJC No Exfi (MC.No:
EUDRIESS:
INSURERS AFFORDING COVERAGE
NAIC p
INSURER A : Nabonal Union Fire Insurance Co. of Pittsburgh, Pa
1995
INSUREDSQUIREPATTON BOGGS (US) LLP
SQUIRE PATTON BOGGS (UK) LLP
ADMINISTRATIVE CENTER
1500 WEST 3RD STREET, STE 450
INSURER B ; Insurance Compalry Of The State Of PA
19429
INSURER C : Commerce And Industry Ins Cc
19410
INSURER D: NIA
NIA
CLEVELAND, OH 44113-1408
INSURER E:
INSURER F :
COVERAGES CERTIFICATE NUMBER: CLE-004109761-05 REVISION NUMBER:I
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
UBR
POLICY NUMBER
POLICY EFF
MMIDDIYYYY
POLICY EXP
MM/DD/YYff
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE MOCCUR
GL 7219312
12131/2014
1213112015
EACH OCCURRENCE
$ 1,000,000
DAMA ET RENTED
PREMISES Ea accun..
1000000
$
MED EXP IAny me person)
$ 10,000
PERSONAL S ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GENL AGGREGATE
X POLICY
LIMIT APPLIES PER:
PRO- LOC
PRODUCTS - COMPIOP AGG
$ 2,000,000
$
A
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED X SCHEDULED
AUTOS AUTOS
NON -OWNED
X HIRED AUTOS X AUTOS
CA 9834120
1213112014
12131/2015
CEOMB DI SINGLE LIMIT
1,000,000
BODILY INJURY (Per Person)
$
BODILY INJURY (Per accitlerd)
S
PROPERTY DAMAGE
Peraccident
$
HIRED COMPICOLL
$ 1,000
C
X
UMBRELLA LAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
BE 023812065
1213112014
1213112015
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5,000,000
DEO I X I RETENTION$ 101000
$
B
A
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY YIN
ANY PROPRIETOR/PARTNERIEXECUTWE�
OFFICERIMEMBER E%CLUDE07 (Mandatory In NH)
It yes, describe under
DESCRIPTION OF OPERATIONS below
N/A
WC 025842870 (ADS)
WC 025842871 ( CA)
12/31/2014
11/3112014
12/3112015
1213112015
WC STATU- ER
E.L. EACH ACCIDENT
1,000,000
$
E.L. DISEASE - EA EMPLOYE
1,000,000
$
E.L. DISEASE -POLICY LIMIT
1,000,000
$
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Mach ACORD 101, Additional Remarks Schedule, If mom apace la required)
The City of Fort Collins, Colorado,
A Municipal Corporation
P.O. Box 580
Fat 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
of Marsh USA Inc.
Polly C. Furey 43uy- e- _A..-
ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD