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Home My WebLink AboutAFLAC INCORPORATED - INSURANCE CERTIFICATE (2)Client#: 103008 30AFLACINCOR ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 5/14/2019 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Connie Whitmer J Smith Lanier 8r Co Columbus PHONE 706-324-6671 Ext : A/C, No 200 Brookstone Centre Pkwy E-MAIL ADDRESS: cwhitmer@jsmithianer.com Suite 118 Columbus, GA 31904 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Great Northern Insurance A++ XV 20303 INSURED INSURER B : Federal Insurance Comapny A++ XV 20281 Aflac Incorporated Pacific Indemnity Company A++ XV INSURER C : y P Y 20346 Attn: Enterprise Risk Management 1932 Wynnton Road INSURER D : Columbus, GA 31999 INSURERE: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 CONTRACTOR 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. LT R LTR TypE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR 35960492 I 5/16/2019 05/16/2020 EACH OCCURRENCE $1 000 000 PREMISES ERENTED nce $1 000 000 MED EXP (Any one person) $10 000 PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PR - POLICY F7X ECT FX I LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 Gen Agg Ca $75,000,000 A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY 73580109 5/16/2019 05/16/202 COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY ( Per accident) $ X PROPERTY DAMAGE Per accident $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 79825301 5/16/2019 05/16/202 EACH OCCURRENCE s25,000,000 AGGREGATE s25,000,000 DED I X RETENTION $$0 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? NJ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 71716058 5/16/2019 05/16/202 OTH• X START TE ER E.L. EACH ACCIDENT $500OOO E.L. DISEASE - EA EMPLOYEE $500000 E.L. DISEASE - POLICY LIMIT s500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) City of Fort Collins 215 North Mason, 2nd Floor Fort Collins, CO 80524-0000 tLLA I IUN 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 Cc) 1998-7515 ACORn CORPORATION_ All riahtc resPrvPrI ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD "0 A 77AAC C IAA A 77A011A f"AAA/