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HomeMy WebLinkAbout563449 CENTERLINE SOLUTIONS LLC - INSURANCE CERTIFICATE (2)ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 2/ 1 /2020 1 /28/2019 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 8110 E. Union Avenue .Suite 700 Denver CO 80237 CONTACT N po% FAX A/C No Ext : A/C No): E-MAIL ADDRESS: INSURER AFFORDING COVERAGE NAIC p (303) 414-6000 INSURER A : Zurich American Insurance Company 16535 INSURED Centerline 1408175 Solutions, LLC 16035 Table Mountain Parkway INSURER 8 : Endurance American Insurance Company 10641 INSURERC: Steadfast Insurance Company 26387 Golden, CO 80403 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 13704033 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/DDfYYYYl LIMITS A X COMMERCIAL GENERAL LIABILITY Y N GLA023211903 2/1/2019 2/1/2020 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE a OCCUR DAMAGE TO RENTED PREMISES Ea occurrence 1 OOO OOO X MED EXP (Any oneperson) 10,000 Contractual Liab • XCU PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. POLICY PE � ❑ LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: A AUTOMOBILE LIABILITY Y N GLA023211903 2/l/2019 2/1/2020 Ea aoold DtSINGLE LIMIT $ 2 OOO OOO X BODILY INJURY (Per person) $ XXXXXXX ANY AUTO OWNED AUTOS ONLY AUTOS BODILY INJURY (Per accident $ XXXXXXX PROPERTY DAMAGE Per accident $ XXXXXXX HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ XXXXXXX B X UMBRELLA LIAB X OCCUR N N EXC30000049903 2/1/2019 2/1/2020 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000 000 EXCESS LIAB CLAIMS -MADE DIED I I RETENTION $ $ XXXXXXX A WORKERS COMPENSATION AND EMPLOYERS' LABILIITY Y/N ANV PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) N / A N WCO23211703 2/1/2019 2/l/2020 X STATUTE DER E.L. EACH ACCIDENT Is 1,000,000 E.L. DISEASE - EA EMPLOYEE Is 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT kz 1,000,000 A C Inst Floater; Leased/Rented Equip Prof/Poll N N CPP023212503 EOC1387313-00 2/1/2019 2/1/2019 2/1/2020 2/1/2020 $1M; $2501Uitem $5M/clm prf, $5M/clm poi; $12M agg; DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Fort Collins, its officers, agents and employees are included as Additional insured as respects General Liability and Automobile Liability as required by written contract. CERTIFICATE HOLDER GANUELLAIIUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 13704033 AUTHORIZED REPRESENTATIVE City of Fort Collins PO Box 580 Fort Collins CO 80522 _ ACORD 25 (2016/03) ©1988-2 5 ACOR6 CORP RATION. All rights reserved The ACORD name and logo are registered marks of ACORD