HomeMy WebLinkAbout523946 CALE AMERICA INC - INSURANCE CERTIFICATE (3)AC� a 7,T,/29/2019
E (MM/DD/YYYY)
C" CERTIFICATE OF LIABILITY INSURANCE
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 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 Susan Kern AAI CIC CPIW
NAME: r
Stahl & Associates Insurance Inc. al� No Ext: (813) 818-5300 FAX No: (613)818-5396
3939 Tampa Road E'MAILs:susan.kern@stahlinsurance.com
ADDRES
INSURER(S) AFFORDING COVERAGE NAIC #
Oldsmar FL 34677 INSURERA:Continental Insurance Co 35289
INSURED INSURERB:Continental Casualty Co 20443
Cale America, Inc. INSURER C -.Valley Fore Ins Co 20508
13190 56th Court INSURER D
Suite 401-402 INSURERE:
Clearwater FL 33760 INSURERF:
COVERAGES CERTIFICATE Nl1MRFR2019 Master RFVIRION NIIMRFR-
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
SUBR
POLICY NUMBER
POLICY EFF
MM/DD
POLICY EXP
MM/DDNYYY
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
CLAIMS -MADE X� OCCUR
DAMAGE TO RENTED
PREMISES Ea occurrence
$ 300,000
MED EXP (Any one person)
$ 15,000
5088231308
1/30/2019
1/30/2020
PERSONAL & ADV INJURY
$ 1,000,000
GENT AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2 , 000 , 000
X POLICY F7 PRO-
JECT ❑ LOC
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
OTHER:
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
X
BODILY INJURY (Per person)
$
B
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
5090882150
1/30/2019
1/30/2020
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
NON -OWNED
HIRED AUTOS AUTOS
X
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5,000,000
A
EXCESS LIAB
CLAIMS -MADE
DED I X I RETENTION$ 10,000
$
5090882178
1/30/2019
1/30/2020
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y I N
WC5090882164 Except CA
1/30/2019
1/30/2020
X STATUTE ERH
C
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
N / A
WC5090882181 (California)
1/30/2019
1/30/2020
E.L. EACH ACCIDENT
$ 1 000 000
E.L. DISEASE - EA EMPLOYE
$ 1,000,000
If Yes, describe under
DESCRIPTION OF OPERATIONS beiow
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
A Tech/Professional E&O
5088231308 1/30/2019
1/30/2020
Each Loss 2,000,000
B ,Installation Floater
5090882195 1/30/2019
1/30/2020
Limit 25,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
The City of Fort Collins are included as Additional Insured as respects General Liability per form
CNA75101XX and Auto Liability Policies, subject to the terms, conditions and exclusions of the policies.
CFRTIFICATF HOI nFR
City of Fort Collins
Director of Purchasing and
Risk Managment
PO Box 580
Fort Collins, CO 80552
ACORD 25 (2014/01) The ACORD
INS025 (201401)