HomeMy WebLinkAbout424631 KENNEDY / JENKS CONSULTANTS - INSURANCE CERTIFICATE (5)ACORfX CERTIFICATE OF LIABILITY INSURANCE
F DATE(MM/DDIYYYY)
10/ 1 /2019
1 9/27/2018
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 Lockton Companies
444 W. 47th Street, Suite 900(PA
Kansas City MO 64112-1906
(816) 960-9000
CONTACT
NAME:
HONE FAX
IC, No, Ext : AIC, No):
E-MAIL
ADDRESS:
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A : Zurich American Insurance Company
16535
INSURED KENNEDY/JENKS CONSULTANTS, INC.
1370659 303 SECOND STREET, SUITE 300 SOUTH
SAN FRANCISCO CA 94107
INSURER B : Lexington Insurance Company
19437
INSURER C
INSURER D :
SURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 12591859 REVISION NUMBER: XXXXXXX
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
INSD
SUBR
WVD
POLICY NUMBER
POLICY EFF
MM/DDIYYYY
POLICY EXP
MM/DDIYYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
Y
N
GL05833581
10/1/2018
10/1/2019
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE OCCUR
X
DAMAGE TO RENTED
PREMISES Ea occurrence
1,000 OOO
MED EXP (Any oneperson)
5,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PE COT- ❑ LOC
GENERAL AGGREGATE
$ 2 000 000
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
OTHER:
A
AUTOMOBILE
LIABILITY
Y
Y
BAP9326879
10/l/2018
10/l/2019
Ea aocldentSINGLE LIMIT
$ 1 0O0 000
X
BODILY INJURY (Per person)
$ XXXXXXX
ANY AUTO
AUTOS ONLY AUTOSULED
X
BODILY INJURY (Per accident
$ XXXXXXX
X
AUTOS ONLY X AUUTO ONLYY ED
PerOaccltlentDAMAGE
$XXXXXXX
$ XXXXXXX
UMBRELLA LIAB
HCLAIMS-MADE
OCCUR
EACH OCCURRENCE
$ XXXXXXX
EXCESS LIAB
NOT APPLICABLE
AGGREGATE
$ XXXXXXX
DED I I RETENTION $
$
A
IONILIT
AND EMPLOYERS'
YERS'LIABILITY
AND EMPLOYERS' LIABILITY y / N
N
WC9326878
10/l/2018
10/1/2019
X STATUTE OER
E.L. EACH ACCIDENT
$ 1,000,000
ANY PROPRIETOR/PARTNER/EXECUTIVE �
OFFICER/MEMBER EXCLUDED?
N / A
E.L. DISEASE - EA EMPLOYEE
1,000,000
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
1 000 000
B
PROFESSIONAL
LIABILITY
N
N
026154151
10/1/2018
10/1/2019
$ 1,000,000 PER CLAIM
$1,000,000 ANNUAL AGGREGATE
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
REF: 7144 GREASE TRAP INSPECTIONS. THE CITY OF FORT COLLINS, ITS OFFICERS, AGENTS AND EMPLOYEES ARE ADDITIONAL
INSUREDS WITH RESPECT TO GENERAL AND AUTO LIABILITY, WHERE REQUIRED BY WRITTEN CONTRACT.
CERTIFICATE HOLDER CANCELLATION
12591859
CITY OF FORT COLLINS
FINANCIAL SERVICES, PURCHASING DIVISION
215 NORTH MASON STREET, 2ND FLOOR
P.O. BOX 580
FORT COLLINS CO 80522-0580
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
I_IK*IG151PwK1lr1*-ff# It31
n1988-2015 ACORD CORPORATION. All riahts rPservPd
The ACORD name and logo are registered marks of ACORD