HomeMy WebLinkAboutMEYER & NAJEM INC - INSURANCE CERTIFICATEACORD" CERTIFICATE OF LIABILITY INSURANCE
�� v1/zo2o
DATE(MM/DD/YYYY)
12/20/2018
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
444 W. 47th Street, Suite 900
Kansas City MO 64112-1906
(816) 960-9000
NAME: T
PH NE FAX
A/C, No, Ext : A/C No):
E-MAIL
ADDRESS:
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A : National Fire Insurance Co of Hartford
20478
INSURED MEYER & NAJEM, INC.
1419876 11787 LANTERN ROAD, SUITE 100
FISHERS IN 46038
INSURER B : Continental Casualty Com anv
20443
INSURER C : Valle Fore Insurance Com anv
20508
INSURER D :
INSURER E
INSURER F
COVERAGES* CERTIFICATE NUMBER: 14556295 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
MM/DD/YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
C
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE � OCCUR
N
N
6016373868
1/1/2019
1/1/2020
EACH OCCURRENCE
1,000,000
PREMISES (Ea olccur ence)
$ 100,000
MED EXP (Any oneperson)15
000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO-
JECT LOC
OTHER.
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
A
AUTOMOBILE LIABILITY
X ANY AUTO
X OWNED AUTOS ONLY AUTOSULED
X AUTOS ONLY X NON-OWNED
ONLDY
N
N
6016373854
1/1/2019
1/1/2020
Ea eaadeDtSINGLE LIMIT
$ 1,000 000
BODILY INJURY (Per person)
$ XXX},}V{X
BODILY INJURY (Per accident
$ XXXXXXX
PerOacclden'DAMAGE
$ XXXXXXX
$XXXXXXX
B
X
UMBRELLA LIAB
EXCESS LIAB
OCCUR
N
N
CUE6016373840
1/1/2019
1/1/2020
EACH OCCURRENCE
$ 15,000,000
NCLAIMS-MADE
AGGREGATE
$ 15,000 000
DED I X I RETENTION $10,000
$ XXXXXXX
C
WORKERS ANDEMPLO ERS'LIABILITY COMPENSATIN YIN
ANY PROPRIETMPARTNEPJFXECUTIVE �
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
It yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
N
6016373837
1/1/2019
1/1/2020
X STATUTE °ER
E.L. EACH ACCIDENT
$ 1,000.000
EL DISEASE - EA EMPLOYEE
Is 1 ,000-000
E.L. DISEASE - POLICY LIMIT
1 000 000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER CANCELLATION
14556295
CITY OF FORT COLLINS
251 N. COLLEGE AVE.
FT. COLLINS CO 80526
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
A(_nRrl 25 l2n1 R/n31
``
v
(c)1- R-2015 ACnRn CnRPORATION_ All rinhts rpcprvprl
The ACORD name and logo are registered marks of ACORD