HomeMy WebLinkAbout424631 KENNEDY / JENKS CONSULTANTS - INSURANCE CERTIFICATE (6)ACORO` CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
10/l/2019
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
Kansas City MO 64112-1906
(816) 960-9000
NAME:
PHONE
Lo, Ext : AC, No
-MA
ADDRESS:
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A: Zurich American Insurance Company
16535
INSURED KENNEDY/JENKS CONSULTANTS, INC.
1370643 303 SECOND STREET, SUITE 300 SOUTH
SAN FRANCISCO CA 94107
INSURER B :
INSURER C
INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 13846187 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
MMIDD/YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
Y
N
GL05833581
10/l/2018
10/1/2019
EACH OCCURRENCE
1,000,000
CLAIMS -MADE OCCUR
DAMAGE TO RENTED
PREMISES Ea occurrence
1,000,000
MED EXP (Any oneperson)
5,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PE � ❑ LOC
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
S 2,000,000
$
OTHER:
A
AUTOMOBILE
LIABILITY
Y
N
BAP9326879
10/1/2018
10/1/2019
(CEa. IND
id.,") SINGLE LIMIT
$ 11000,000
X
BODILY INJURY (Per person)
$ XXXXXXX
ANY AUTO
OWNED
AUTOS ONLY SCHEDULED
X
BODILY INJURY (Per accident
$ XXXXXXX
X
AUTOS ONLY X NON-OWNED
ONLYY
PerOaccidentDAMAGE
$XXXXXXX
$ XXXXXXX
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$ XXXXXXX
EXCESS LIAB
CLAIMS -MADE
NOT APPLICABLE
AGGREGATE
$ XXXXXXX
12
DED I I RETENTION $
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY y / N
N
WC9326878
10/l/2018
10/1/2019
X STATUTE o R
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 (f ysdescribe under
Ie,
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT is
1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: 8149 GREASE INTERCEPTOR INSPECTIONS. CITY OF FORT COLLINS, ITS OFFICERS, AGENTS AND EMPLOYEES ARE ADDITIONAL
INSURED AS RESPECTS GENERAL AND AUTO LIABILITY, AS REQUIRED BY WRITTEN CONTRACT.
CERTIFICATE HOLDER CANCELLATION
13846187
CITY OF FORT COLLINS
ATTN: DIRECTOR OF PURCHASING
AND RISK MANAGEMENT
P.O. 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
ACORD 25 (2016/031
Cc�14RR_7015 GCnRn CnRpnROTInN All rinhtc rocamarl
The ACORD name and logo are registered marks of ACORD