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HomeMy WebLinkAbout590416 SQUIRE PATTON BOGGS (US) LLP - INSURANCE CERTIFICATEl ® R' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDYYYY) 16. 01/0212019 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 NAME. '(FAX Marsh USA Inc. PHONE A/C No : E-MAIL ADDRESS: 200 Public Square Suite 1000 Cleveland, OH 44114 INSURERS AFFORDING COVERAGE NAIC # INSURER A: National Fire Insurance Company of Hartford 20478 CN102966455—Cas-18-19 IN SRE Ee Patton Boggs (US) LLP INSURER B : National Union Fire Ins Cc Pittsburgh PA 19445 INSURER C : NIA N/A Squire Patton Boggs (UK) LLP INSURER D : Insurance Company Of The State Of Pennsylvania 19429 Administrative Center 1500 West 3rd, Suite 450 Cleveland, OH 44113 INSURER E : NIA N/A INSURER F : COVERAGES CERTIFICATE NUMBER: CLE-006203761-04 REVISION NUMBER: 2 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. INSRPOLICY LTR TYPE OF INSURANCE IN= Wvp SUER POLICY NUMBER MM DD YYYY Y MMIDDYYY LIMITS A X COMMERCIAL GENERAL LIABILITY 6056540723 12/31/2018 12/31/2019 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR DAMAZEDU'TED PREMISES Ea occurrence) $ 100,000 MED EXP (Any one person) $ 15,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 JECT POLICY ❑ PRO ❑ LOC X PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER. AUTOMOBiLELIABILiTY 3761837 12/31/2018 12/31/2019 COMEaaccBINEDidentSINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS Owned Comp/Coll: $500/$500 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Hired Comp/Coll:$1,000/$1,000 UMBRELLALIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAB DED I I RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) N / A WC 14220773 (AOS) WC 14220774 (CA) 12/31/2018 12/31/2019 12/31/2019 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below 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/are included as additional insured, where required by written contract, as respects the General and Auto Liability policies. CERTIFICATE HOLDER CANCELLATION City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO BOX 580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Fort Collins, CO 80522 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Michael R. Jackisch 04,(or Lty e \74e-&lfe_� ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD