HomeMy WebLinkAbout426136 MUNICIPAL EMERGENCY SERVICES - INSURANCE CERTIFICATE (4)ACORO" CERTIFICATE OF LIABILITY INSURANCE
12/29/2019
F DATE(MM/DD/YYYY)
12/ 13 /20 l 8
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
NAME:
PHONE FA
A/c, No EXt : A/c No):
76 Batterson Park Road
Farmin(7{ton CT 06032
860-679-4000
E-MAIL
ADDRESS:
INSURER AFFORDING COVERAGE
NAIC #
INSURER A: Travelers Indemnity Company of America
25666
INSURED Municipal Emergency Services, Inc.
INSURER B: Navigators Insurance Company
42307
INSURER C : Travelers Property Casualty Co of America
25674
1372711 7 Poverty Road, 85H Bennett Square
Southbury CT 06488
D
-INSURER
INSURER E
INSURER F
COVERAGES CFRTIFICATF NHMRFR- 1 5599632 REVISION NUMBER: XXXXXXX
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED -10 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
VWD
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
q
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE � OCCUR
Y
N
630-3639A484
12/29/2018
12/29/2019
EACH OCCURRENCE
1,000,000
DAMPREMISESOEa occur ante
1,000,000
MED EXP (Any oneperson)
10,000
PERSONAL & ADV INJURY
$ 1,000 000
GEN'JECT L AGGREGATE LIMIT APPLIES PER
POLICY❑ PRO- ❑ LOC
OTHER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED AUTOSNON-OWNEDPROPERTY
AUTOS ONLY AUTOS ONLYLY
Y
N
810 3639A515
12/29/2018
12/29/2019
Ea aocdentSINGLE LIMIT
$ 1 000 000
X
BODILY INJURY (Per person)
$ XXXXXXX
BODILY INJURY (Per accident
$ XXXXXXX
DAMAGE
Per accident
$XXXXXXX
$XXXXXXX
B
X
UMBRELLA LIAB
EXCESS LIAR
OCCUR
CLAIMS -MADE
N
N
B018UMR8004421V
12/29/2018
12/29/2019
EACH OCCURRENCE
$ 10,000,000
AGGREGATE
$ 10,000,000
DED I X I RETENTION $ 10,000
$ XXXXXXX
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANV PROPRIETOR/PARTNER/EXECUTIVE
OF EXCLUDED N❑
(Mandatory in NH)
yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
N
UB-I L70309A
l2/29/2018
12/29/2019
X STATUTE ER
E.L. EACH ACCIDENT
$ 11000,000
E.L. DISEASE - EA EMPLOYEE
1,000,000
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)
City of Fort Collins is included as additional insured with regards to General Liability and Auto Liability as required by written contract.
CERTIFICATE HOLDER l.ANk CLLAI IVry
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
15598632
AUTHORIZED REPRESENTATIVE
City of Fort Collins
PO BOX 580
Fort Collins, CO 80522
(C)'1988-201,9'ACOAD CORPORATION. All rights reserved
The ACORD name and logo are registered marks of ACORD