HomeMy WebLinkAbout556475 ZAGSTER INC - INSURANCE CERTIFICATE (4)AC"R" ® DATE (MM/DD/YYYY)
A-- CERTIFICATE OF LIABILITY INSURANCE 9/18/2018
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
NAME:
Arthur J. Gallagher Risk Management Services, Inc. PHONE Fax
470 Atlantic Avenue A/c No : 617-261-6700 ac No :617 646-0400
E-MAI L
Boston MA 02210 ADDRESS:
INSURER(S) AFFORDING_ COVERAGE NAIC #
INSURER A: Associated Industries Insurance Co, Inc 23140
INSURED ZAGSINC-01 INSURER s : Hartford Accident and Indemnity Company 22357
Zagster, Inc. INSURER c : Endurance American Insurance Company 10641
50 Milk Street
Boston MA 02109 INSURER D : Hartford Underwriters Insurance Company 30104
INSURER E :
rOVFRAnFS rFRTIFICATF HIIMRFR-FnmS9aa REVISION N(IMRFR-
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 TYPE OF INSURANCE AINYL sR POLICY EFF POLICY NUMBER MMIDD/YYY MIJC/YYYY LIMITS
LTR
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE x OCCUR
AES105358601
6/102018
9/10/2019
EACH OCCURRENCE
$1,000.000
PREMII&ES Ea occurrence)$1,000,000
MED EXP (Any one person)
$ EXCLUDED
_
PERSONAL & ADV INJURY
$1,000,000
_
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY PRO-
JECT F7 LOC
OTHER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
B
AUTOMOBILE LIABILITY
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
OBUECAZ6483
9/102018
GYIOr 019
CEa accOMBINED SINGLE LIMITident
$1,000.000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
C
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
ELD30000690700
6/102018
9/102019
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$5,000,000
DED RETENTION$
$
p
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY Y/N
ANYPROPRIETOR/PARTNER/EXECUTIVE ❑
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N/A
08WECAB5Z3V
9/102018
9/102019
XIP
STATUTE I I ER
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE - EA EMPLOYEE
$1,000.000
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)
Certificate Holder is an Additional Insured as respects to the General Liability and Auto Liability policies, pursuant to and subject to the policy's terms,
definitions, conditions and exclusions.
rFRTIFICATF HOI ❑FR CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Fort Collins
PO BOX 580
AUTHORIZED REPRESENTATIVE
,
Fort Collins CO 80522
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U 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD