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HomeMy WebLinkAbout404702 COPLOGIC INC - INSURANCE CERTIFICATE (3)A o CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) I 12/22/2016 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. Boston MA Office CONTACT NAME: (A/CO-NN. Ext): (866) 283-7122 (A/C. No.): (800) 363-0105 E-MAIL ADDRESS: 53 State Street Suite 2201 Boston MA 02109 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: ACE American Insurance Company 22667 CoDlogic, a RELX Inc Company 231 Market Place Suite 520 INSURERB: Lloyd's Syndicate No. 2623 AA1128623 INSURERC: Zurich Insurance Plc AA1780059 San Ramon CA 94583 USA INSURER D: Zurich American Ins Co 16535 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570074373275 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 INSR LTR TYPE OF INSURANCE I D INSD UB WVD POLIPOLICYNUMBER ID MMIDD/YYYY POLICY IDDr EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY OGLG 1 EACH OCCURRENCE $1, 000 , 000 CLAIMS -MADE X❑ OCCUR DAMAGE TRENTED PREMISES Ea occurrence $1,000,000 MED EXP (Anyone person) $ 5 , 000 PERSONAL &ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 X POLICY ❑ PRO ❑ LOC JECT PRODUCTS - COMP/OP AGG $2,000,000 OTHER: Liquor Liability Lim $5,000,000 D AUTOMOBILE LIABILITY 8376848 20 01/01/2019 01/01/2020 COMBINED SINGLE LIMIT Ea accident $5,000,000 BODILY INJURY ( Per person) X ANYAUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED ONLY AUTOS ONLY PROPERTYDAMAGE (Per accident) X Collision Ded $1,000 rX1Comp Ded $1,000 C UMBRELLA LIAB X OCCUR 7053081 01/01/2019 12/31/2019 EACH OCCURRENCE $5,000,000 X EXCESS LIAB CLAIMS -MADE AGGREGATE $5,000,000 DED RETENTION D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR/PARTNER/EXECUTIVE 837684520 01/01/2019 01/01/2020 X PER OTH- STATUTE ER 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 unde, DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 11,000,000 B E&O-PL-Primary FSCE01900015 O1/O1/2019 12/31/2019 Aggregate Limit $3,000,000 SIR applies per policy terns & condi ions Per Occurence $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) City of Fort Collins is added as additional insured on the General Liability subject to the policy limitations, conditions and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins AUTHORIZED REPRESENTATIVE 300 LaPorte Ave Fort Collins CO 80521 USA eX1'o�a ���:�Dfc c%LtYcrd c//.�` e J eau u� r N C) 0 0 Lo O Z O l0 U w 0) L) ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000055869 LOC #: ADDITIONAL REMARKS SCHEDULE Page _ of AGENCY Aon Risk Services Northeast, Inc. NAMED INSURED Coplogic, a RELX Inc Company POLICY NUMBER See Certificate Number: 570074373275 CARRIER See Certificate Number: 570074373275 NAIC CODE EFFECTIVE DATE ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICYNUMBER POLICY EFFECTIVE DATE MM/DD/YYYY) POLICY EXPIRATION DATE MM/DD/YYYVI LIMITS OTHER C E&O-PL-XS FSCE01900059 01/01/2019 12/31/2019 Any One Claim $10,000,000 Aggregate $10,000,000 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000055869 LOC #: A ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Services Northeast, Inc. NAMED INSURED CoDloaic. a RELX Inc COmOanv POLICY NUMBER see certificate Number: 570074373275 CARRIER ----fNAIC see Certificate Number: 570074373275 CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Companies Affording coverage LINE OF BUSINESS DESCRIPTION POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YYYY) POLICY EXPIRATION DATE (MM/DD/YYYY) COMPANY NAIC PRIMARY (Y/N) FLAG PERCENTAGE OF RISK E&O - Professional Liability - Excess FSCE01900059 1/1/2019 12/31/2019 Zurich Insurance Plc AA1780 Y 100 Excess Liability Coverage 7053081 1/1/2019 12/31/2019 Zurich Insurance Plc AA1780 Y 100 Workers Compensation - Casualty 837684520 1/1/2019 1/1/2020 Zurich American Ins Co 16535 Y 100 Business Auto Coverage 8376848 20 1/1/2019 1/1/2020 Zurich American Ins Co 16535 Y 100 E&o - Professional Liability - Primary FSCE01900015 1/1/2019 12/31/2019 Lloyd's Syndicate No. 2623 AA1128 Y 82 E&o - Professional Liability - Primary FSCE01900015 1/1/2019 12/31/2019 Lloyd's Syndicate No. 623 AA1126 N 18 General Liability Coverage OGLG24876512 1/1/2019 1/1/2020 ACE American insurance Company 22667 Y 100 The Subscribing insurers' obligations under contracts of insurance to which they subscribe are several and not joint and are limited solely to the extent of their individual subscriptions. The subscribing insurers are not responsible for the subscription of any co -subscribing insurer who for any reason does not satisfy all or part of its obligations. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD