HomeMy WebLinkAboutNATIONAL MULTIPLE SCLEROSIS SOCIETY - INSURANCE CERTIFICATE (4)® 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
MARSH USA, INC.
445 SOUTH STREET
MORRISTOWN, NJ 07960-6454
Attn: Morristown. CeftRequest@marsh.com Fax: 212-948-0979
_ DENVE
INSURED
NATIONAL MULTIPLE SCLEROSIS SOCIETY
COLORADO - WYOMING CHAPTER
900 S. BROADWAY #250, 2ND FLOOR
DENVER,CO 80209
COVERAGES
CERTIFICATE NUMBER
INSURER A: Federal Insurance
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
NYC-009895459-21
REVISION NUMBER' 2
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
SUER
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE X OCCUR
3583-33-49
12/31/2018
12/31/2019
EACH OCCURRENCE
$ 1,000,000
DAMA E T RENTED
PREMISES Ea occurrence
$ 1,000,000
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER:
PRO -
POLICY JECT LOC
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 1,000,000
$
OTHER:
A
AUTOMOBILE
LIABILITY
ANY AUTO
7353-02-37
12/31/2018
12/31/2019
COMBINED SINGLE LIMIT
En accident
$ 1,000,000
X
BODILY INJURY (Per person)
$
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY P
(Per accident)
$
HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
X
PROPERTY DAMAGE
Per accident
$
Comp/Coll Deductible
$ 1,000
X
UMBRELLALIAS
X
OCCUR
9364-93-75
12/31/2018
12/31/2019
EACH OCCURRENCE
$ 5,000,000
__.
AGGREGATE
$ 5,OOQ000
EXCESS LIAB
CLAIMS -MADE
X
DED RETENTION $
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANYPROPRI ETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? �
N / A
71763467
12/31/2019
X PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$ 1,000,000
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 I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CITY OF FORT COLLINS IS INCLUDED AS ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT, BUT LIMITED TO THE OPERATIONS OF THE INSURED UNDER SAID CONTRACT, PER THE
APPLICABLE ENDORSEMENT WITH RESPECT TO THE GENERAL LIABILITY AND AUTOMOBILE LIABILITY POLICIES,
r rv11 �,AfYLGLLA I lUN
CITY OF FORT COLLINS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
ATTN: LANCE MURRAY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
PO BOX 580 ACCORDANCE WITH THE POLICY PROVISIONS.
FORT COLLINS, CO 80522
AUTHORIZED REPRESENTATIVE
of Marsh USA Inc.
Manashi Mukherjee
iJ 1988-2016 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD