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PARKEON INC - INSURANCE CERTIFICATE (3)
CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 11/16/2018 I 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 AOn Risk Services Northeast, Inc. New York NY Office CONTACT NAME: PHONE A/C. N. Ext): (866) 283-7122 (aC No.): (800) 363-0105 E-MAIL ADDRESS: One Liberty Plaza 165 Broadway, suite 3201 INSURER(S) AFFORDING COVERAGE NAIC # New York NY 10006 USA INSURED INSURER A: ACE Property & Casualty Insurance Co. 20699 Parkeon. Inc. INSURERB: ACE American Insurance Company 22667 40 Twosome Dr. Unit 7 Moorestown N7 08057 USA INSURER C: The Travelers Indemnity Co of CT 25682 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570073934205 REVISION NUMBER: 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. Limits shown are as requested ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD MM DD LIMITS B X COMMERCIAL GENERAL LIABILITY OGLG 4 1 1 1 1 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X❑ OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $1,000,000 MED EXP (Any one person) $10 , 000 PERSONAL& ADV INJURY $1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $1,000,000 POLICY PRO ❑ LOC JECT PRODUCTS - COMPIOPAGG $1,000,000 SIR/Deductible $10, 000 OTHER: C AUTOMOBILE LIABILITY BA11_505810 11/17/2018 11/17/2019 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY ( Per person) AINYAUTO X BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HI RED AUTOS NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGE Per accident Comp/Coll Deductible $11000 A X UMBRELLA LIAB X OCCUR XOOG24997194 01/01/2018 01/01/2019 EACH OCCURRENCE $10,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $10,000,000 DED I X RETENTION$ 10, 000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY IN ANY PROPRI ETOR I PARTNER/EXECUTIVE Y❑ U1311-650110 11/17/2018 11/17/2019 X STATUTE ERH E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS belowE.L. DISEASE -POLICY LIMIT $1, 000, O00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Evidence of Coverage m 0 N m rn 0 r- Lo O Z d f0 V d U CERTIFICATE HOLDER CANCELLATION _? f _ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE ,y POLICY PROVISIONS. City Of Fort Collins AUTHORIZED REPRESENTATIVE 215 N Mason St. Fort Collins Co 80524 USA c�ron is%G:tGiG r� c./!"crGt �n� �' ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD