HomeMy WebLinkAboutNATIONAL MULTIPLE SCLEROSIS SOCIETY - INSURANCE CERTIFICATE (2)Ago CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
01/03/2019
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 CONTACT
MARSH USA, INC. NAME:
445 SOUTH STREET PHONE j FAx
Q. Ext): 1 A/C No
MORRISTOWN, NJ 07960-6454 E-MAIL
Attn: Morristown.CertRequest@marsh.com Fax: 212-948-0979 ADDRESS:
DENVE
INSURED
NATIONAL MULTIPLE SCLEROSIS SOCIETY
COLORADO - WYOMING CHAPTER
900 S. BROADWAY #250, 2ND FLOOR
DENVER,CO 80209
INSURER(S) AFFORDING
INSURER A: Federal Insurance Company
INSURER B :
INSURER C :
INSURER D :
INSURER E :
COVFRAnFR r1:PT1CIrAT9: NII IRAr211=110• niVr' nnnnnoc7o 17
NAIC N
20281
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
SUBR
POLICY NUMBER
POLICY EFF
MMlDDNYYY1
POLICY EXP
1MM/DD1YYYYl
UMITS
A
X
COMMERCIAL GENERAL LIABILITY
3583-33-49
12/31/2018
12/31/2019
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE AI OCCUR
PREMISES Ea occur ence
$ 1,000,000
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
PRO -
POLICY FX I
JECT LOC
PRODUCTS - COMP/OP AGG
$ 1,000,000
$
OTHER
A
AUTOMOBILE
LIABILITY
7353-02-37
12/31/2018
12/31/2019
COMBu-'eINED SINGLE LIMIT
Ea acnl`
$ 1,000,000
ANY AUTO
X
BODILY INJURY (Per person)
$
OWNED SCHEDULED
AUTOS ONLY _ AUTOS
BODILY INJURY (Per accident)
$
HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
X
PROPERTY DAMAGE
Per accident
$
Comp/Coll Deductible
$ 1,000
X
UMBRELLA LIAB
X
OCCUR
9364 93 75
12/31/2018
12/31/2019
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5,000,000
EXCESS LIAB
CLAIMS -MADE
X
DEO I I RETENTION $
$
A
WORKERS COMPENSATION
71763467
12/31/2019
X PER OTH-
AND EMPLOYERS' LIABILITY Y / N
STATUTE ER
E.L.EACH
$ 1,000.000
ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? �
NIA
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
(Mandatory in NH)
If yes, describe under
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS below
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, EMPLOYEES AND VOLUNTEERS ARE ADDED AS ADDITIONAL INSURED EXCLUDING WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY
POLICY AS REQUIRED BY WRITTEN CONTRACT BUT LIMITED TO THE OPERATIONS OF THE INSURED UNDER SAID CONTRACT, AND ALWAYS SUBJECT TO THE POLICY TERMS, CONDITIONS AND
EXCLUSIONS. LIQUOR LIABILITY COVERAGE IS INCLUDED IN THE ABOVE REFERENCED GENERAL LIABILITY POLICY.
-,arc I Irn iA i rz nULLJr- ( CANCELLATION
CITY OF FORT COLLINS
ATTN: RISK MANAGEMENT
P.O. BOX 580
FORT COLLINS, CO 80522-0580
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
of Marsh USA Inc.
Manashi Mukherjee
U 19BB-2016 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD