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HomeMy WebLinkAboutGOODWILL INDUSTRIES OF DENVER - INSURANCE CERTIFICATE (4)A`CORO® CERTIFICATE OF LIABILITY INSURANCE D08/31/2018aYYYY) 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 NAME' MARSH USA INC. _ 122517TH STREET, SUITE 1300 �CCN_Q Exu: A/c No). DENVER, CO 80202-5534 E-MAIL Attn: DENVER.CERTREQUEST@MARSH.COM FAX. (212) 948-4381 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # _ INSURER A: Philadelphia Indemnity Insurance Company 18058 CN101410245-STND-GAWU-18-19 INSURED GOODWILL INDUSTRIES OF DENVER INSURER B : Plnnacol Assurance 41190 INSURER C : 6850 NORTH FEDERAL BOULEVARD DENVER, CO 80221 INSURER D INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: SEA-003351131-07 REVISION NUMBER: 1 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 SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY PHPK1873458 09/01/2018 09/01/2019 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE I v� OCCUR DAMAGE T RENTED PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 20,000 PERSONAL & ADV INJURY $ 1,000,000 GEN1 AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 3,000,000 POLICY ❑ PRO - POLICY ❑ LOC X PRODUCTS - COMPIOP AGG $ 3,000,000 $ OTHER A AUTOMOBILE LIABILITY PHPK1873458 09/01/2018 09/01/2019 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY _ _ AUTOS BODILY INJURY (Per accident) $ X PROPERTYDAMAGE Per accident $ HIRED X NON -OWNED AUTOS ONLY _ AUTOS ONLY X UMBRELLA LIAR X OCCUR PHUB645237 09/01/2018 09/01/2019 EACH OCCURRENCE $ 10,000,000 AGGREGATE EXCESS LIAB CLAIMS -MADE $ 10,000,000 DIED I X I RETENTION $10 000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORlPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑N (Mandatory in NH) NIA 4133992 09/01/2019 X PER I OTH- STATUTE I i ER E.L. EACH ACCIDENT _ $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1.1)00 000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is additional insured as respects to auto liability and general liability, where required by written contract. The following Contract Term shall be: 9-1-16 through 8-31-17. CERTIFICATE HOLDER CANCELLATION City of Fort Collins PO Box 580 Ft. 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