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HomeMy WebLinkAbout449502 KUBRA DATA TRANSFER LTD - INSURANCE CERTIFICATE/ 1 ® DATE (MM/DD/YYYY) oRD CERTIFICATE OF LIABILITY INSURANCE 03104/201; 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). CONTACT PRODUCER NAME: Marsh USA, Inc. PHONE - _ PAX 1166 Avenue of the Amencas - - - lac. NOI` - -- New York, NY 10036 E-MAIL ADORE -- Attn. newyork.certs@marsh.com .um oac°lm eccrwrvur nnvaae GF NAIL • 034835-'MAIN-'ALL'44.15 KUBRA INSURER A: Travelers Property Casually Go. of America INSURED INSURER B : NSA KUBRA DATA TRANSFER LTD. 2961 SIDCO DRIVE INSURER C NASHVILLE, TN 37204 INSURER D : INSURER E : rrwcownvc r`POTImrATF NIIMRFR: NYC-007015794-04 REVISION NUMBER:2 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVVITHSTANDING 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. INSRAD DL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYV MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $_UAM1,000,000 A X COMMERCIAL GENERAL LIABILITY TC2JGLSA-178D35o4TIIa4 0710112014 07/01/2015 A ET RENTED 1,000,000 PREMISES Ea occurrence $ CLAIMS -MADE I -XI OCCUR MED EXP (Any one person) $ 10,000 PERSONAL a ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGG $ 1,000,000 X POLICY PRO- LOC S COMBINED SINGLE LIMIT 1,000,000 AUTOMOBILE LIABILITY _& accident BODILY INJURY (Per person) $ A X TC2JCAP-178D353A-TIL-14 07MI12014 07/01/2015 ANY AUTO BODILY INJURY Per accident) $ - X ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED PROPEWeracCTnDAMAGE $ X HIREDAUTOSAUTOS N - $ UMBRELLA UAB OCCUR EACH OCCURRENCE S AGGREGATE EXCESS UAB CLAIMS -MADE $ DED I I RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) NIA $ - E.L. DISEASE -POLICY LIMIT If yes describe under DESCRIPTION OF OPERATIONS below s I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It more space is required) CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED WHERE REQUIRED BY WRITTEN CONTRACT. 1 C r1W1_IJ1Z1[ CITY OF FORT COLLINS ATTN:GERRY PAUL DIRECTOR OF PURCHASING 6 RISK MANAGEMENT PO BOX 580 FORT 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. Daniel Rivera V ItI50-LU1U AVVKV I UMIr UKAI IVrv. rill 11911r01WOW' ♦WU. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ATE CERTIFICATE OF LIABILITY INSURANCE I D02/27/2015Dnvvv) 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 CONTACT NAME ___ Marsh USA. Inc. PHONE FAX 1166 Avenue of the Americas AA/C. No. ExD: _ (AIC. No): New York, NY 10036 E-MAIL ADDRESS: Attu: newyork.certs@marsh.com ,.,.,..Le.�. 034835-'MAIN-'ALL' 14-15 KU_BRA _ _ INSURER A: Travelers Property Casualty Co. of America 25674 INSURED INSURERS: NIA N/A KUBRA DATA TRANSFER LTD. 2961 SIDCO DRIVE INSURER C : NASHVILLE,TN 37204 INSURER D: INSURER E : INSURER F : COVERAGES CFRTIFICATF Milli NYC-007015794-02 REVISION NUMBER:1 vTHIS 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 A L INqR U R WVn POLICY NUMBER POLICY EFF MM/DDIYYYY PODCY EXP MMIDD/YYYY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE 6 DAMA R N PR MI E Ea occurrence) S MED EXP (Any one Person) $ PERSONAL B ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER. POLICY r PRO LOC PRODUCTS - COMP/OP AGG $ $ A AUTOMOBILE LIABILITY I ANY AUTO ALL OWNED X SCHEDULED AUTOSNON-OWNED HIRED AUTOS X AUTOS TC2JCAP-178D353A-TIL-14 0710112014 07101/2015 EOMaBIINEDSINGLE LIMIT 1,000,000 BODILY INJURY (Per Person) 9 BODILY INJURY (Per accident) SAUTOS PROPERTY DAMAGE Per aaidenl S a UMBRELLA LU18 EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA VuC STATU- OTH- B FR E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT I 6 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If mom space is required) CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED WHERE REQUIRED BY WRITTEN CONTRACT. CFRTIFICATF Hr11 DFR CANCELLATION CITY OF FORT COLLINS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN, GERRY PAUL THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN DIRECTOR OF PURCHASING & RISK MANAGEMENT ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 580 FORT COLLINS, CO 80522 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Daniel Rivera ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD