HomeMy WebLinkAbout426136 MUNICIPAL EMERGENCY SERVICES - INSURANCE CERTIFICATE (7)ACORl�' CERTIFICATE OF LIABILITY INSURANCE
`64� 12/29/2019
DATE(MM/DDfYYYY)
12/13/2018
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
CONTACT
NAME:
PHONE PAX
A/C, No Ext : A/C No):
76 Batterson Park Road
Farminaxgton CT 06032
860-6714000
E-MAIL
ADDRESS:
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A : Travelers Indemnity Company of America
25666
INSURED Municipal Emergency Services, Inc.
INSURER B : Navigators Insurance Company
42307
1372711 7 Poverty Road, 85H Bennett Square
Southbury CT 06488
INSURER C : Travelers Property Casualty Co of America
25674
INSURER D
INSURER E :
INSURER F
COVERAGES CERTIFICATE NUMBER: 15598632 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
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
Y
N
630-2528A484
12/29/2018
12/29/2019
EACH OCCURRENCE
1,000,000
DAMAGE TO RENTED
PREMISES Ea occurrence
1,000,000
MED EXP (Any oneperson)1
O OOO
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY JERCOT LOC
OTHER
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 21000,000
1
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED SCHE
AUTOS ONLY AUTODULED
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
Y
N
810 3639A515
12/29/2018
12/29/2019
(COeBIN DtSINGLE LIMIT
$ 1,000,000
X
BODILY INJURY (Per person)
$ XXXXXXX
BODILY INJURY (Per accident
$ XXXX}{xx
PROPERTY DAMAGE
Per accident
$XXXXXXX
$ XXXXXXX
B
}{
UMBRELLA LIAB
EXCESS LIAB
OCCUR
N
N
B018UMR8004421V
12/29/2018
12/29/2019
EACH OCCURRENCE
$ 10,000,000
HCLAIMS-MADE
AGGREGATE
$ 10,000,000
DED I X I RETENTION $ 10,000
$ XXXXXXX
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? FN (Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
N
UB-IL70309A
12/29/2018
12/29/2019
PER OTH-
X STATUTE ER
E.L. EACH ACCIDENT
$ 1,000,000
F L DISEASE - EA EMPLOYFE
$ 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 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.
15598632
AUTHORIZED REPRESENTATIVE
City of Fort Collins
PO BOX 580
Fort Collins, CO 80522
ACORD 25 (2016/031 @111988-2011ACOAD CORPORATION. All rights reserved
The ACORD name and logo are registered marks of ACORD