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HomeMy WebLinkAboutGOODWILL INDUSTRIES OF DENVER - INSURANCE CERTIFICATE (2)® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 08/31 /2018 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 have ADDITIONAL INSURED provisions or 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 MARSH USA INC. NAME: PHONE FAX 122517TH STREET, SUITE 1300 (A/C. No. Ext[ A/C No): DENVER, CO 80202-5534 E-MAIL Attn: DENVER.CERTREQUEST@MARSH.COM FAX: (212) 9484381 ADDRESS: CN101410245-STND-GAWU-18-19 INSURED GOODWILL INDUSTRIES OF DENVER 6850 NORTH FEDERAL BOULEVARD DENVER, CO 80221 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Philadelphia Indemnity Insurance Company 18058 INSURER B : Pinnacol Assurance 41190 INSURER C : E: COVERAGES CERTIFICATE NUMBER: SEA-003502400-04 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. 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. I NSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MM` POLICY EFF POLICY EXP LTR DD/YYYY MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY PHPK1873458 09/01/2018 09/01/2019 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE 1XI OCCUR PREMISES Ea occur ence $ 1,000,000 MED EXP (Any one person) $ 20,000 PERSONAL & ADV INJURY $ 1,000,000 GENE AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 3,000,000 X PRO ❑ LOC POLICY ❑ JEC7 PRODUCTS - COMP/OP AGG $ 3,000,000 $ OTHER A AUTOMOBILE LIABILITY PHPK1873458 09/01/2018 09/01/2019 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ X HIRED Ix NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) N/A 4133992 09/01/2019 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 -- E L DISEASE - EA EMPLOYEE - $ 1 ��0�000 If yes describe under DESCRIPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT $ 1,000.000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is named as additional insured as respects general liability policy where required by written contract. CERTIFICATE HOLDER CITY OF FORT COLLINS 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. Nathan Mulhauser r- ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD