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RUBINBROWN LLP - INSURANCE CERTIFICATE
ACORO° CERTIFICATE OF LIABILITY INSURANCE 11 / 16/2019 DATE(MMIDD/YYYY) 11 / 14/2018 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 Three City Place Drive, Suite 900 St. Louis MO 63141-7081 (314) 432-0500 CONTACT NAME: HONE FAX o Ext : A/C No): A/C No, E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: National Fire Insurance Co of Hartford 20478 INSURED RubinBrown, LLP 1387500 One North Brentwood Boulevard St. Louis MO 63105 INSURER B : American Casualty Company of Reading, PA 20427 INSURER C : INSURER D : INSURER E : INSURER F : rnVFRAfSFR rFRTIFIrtATF NIIMRFR• 11711?5Z6 RFVISION NIIMRFR- 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 DD POLICY EXP MM DD LIMITS A X COMMERCIAL GENERAL LIABILITY N N 6043655949 11/16/2018 11/16/2019 EACH OCCURRENCE s 1,000,000 DRAMEMISES AGE TOEa RENTE PoccurDrence 500,000 CLAIMS -MADE T OCCUR MED EXP (Any oneperson) 15,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑ JECT FX LOC I PRODUCTS - COMP/OP AGG S 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident s XXY—XXXX ANY AUTO NOT APPLICABLE BODILY INJURY (Per person) $ YYYYY,,KX AUTOS ONLY SCHEDULED AUTOS BODILY INJURY (Per accident $ PROPERTY DAMAGE Per accident $ X3�XX3�3�� HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ XXXYXXX EXCESS LIAB CLAIMS -MADE NOT APPLICABLE AGGREGATE $ XXXxXXX DED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A N 4013789960 11/16/2018 11/16/2019 X STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE 1,000,000 SCd—ribe under DEes RIPTION OF OPERATIONS below 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) A THIRTY (30) DAY NOTICE OF CANCELLATION FOR GENERAL LIABILITY COVERAGE WILL BE PROVIDED FOR REASONS OTHER THAN NON-PAYMENT OF PREMIUM. CERTIFICATE HOLDER CANCELLATION See Attachment 13711286 CITY OF FORT COLLINS PURCHASING FINANCIAL SERVICES PURCHASING DIVISION 215 N. MASON ST. 2ND FLOOR PO BOX 580 FORT COLLINS, CO 80522 ACORD 25 f2016/031 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ATNE ©1988Il tFACORD CORISORATMN. All rights reserved The ACORD name and logo are registered marks of ACORD