HomeMy WebLinkAboutCARRIER CORPORATION - INSURANCE CERTIFICATE (9)A�C)RD� CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
03126/2019
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.
CONTACT
NAME: --
PHONE FAX
LA[c No. Ex(1_ A/c No :
20 CHURCH STREET, 8TH FLOOR
HARTFORD, CT 06103
E-MAIL
ADDRESS:
INSURERS AFFORDING COVERAGE NAIC #
INSURER A : Hartford Fire Insurance Company
19682
101 479273-CCS-GAWX-1 9-20 _ _
INSURED CARRIER CORPORATION
INSURER B : Hartford Underwriters Insurance Company
30104
INSURER c : National Union Fire Ins Co Pittsburgh PA
19445
13995 PASTEUR BLVD
PALM BEACH GARDENS, FL 33458
INSURER D : American Home Assurance Company
19380
INSURER E: New Hampshire Ins. Co.
23841
INSURER F : N/A
N/A
COVERAGES CERTIFICATE NUMBER: NYC-010.565870-02 RF\/ICtrlAl MI IMRFR• n
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
T TYPE OF INSURANCE
ADDL
SUER
POLICY NUMBER
POLICY EFF
MM/DD/YYYYI
POLICY EXP
(MM/DD1YYYYl
_ - --
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE r l OCCUR
02CSET10004
$2,000,000 General Aggregate
04/01/2019
04/01/2020
EACH OCCURRENCE
_$ 1,000,000
$ 300,000
DAMAGE T RENTED
PREMISES Ea occurrence
MED EXP (Any one person)
$ 10,000
Per Project / Location
PERSONAL & ADV INJURY
$ 1,000,000
$10,000,000 General Aggregate
GENT
X
AGGREGATE LIMIT APPLIES PER
PRO-
POLICY � JECT a LOC
GENERAL AGGREGATE
$ 2,000,000
Per Policy
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
OTHER
A
B
AUTOMOBILE
LIABILITY
ANY AUTO
02CSET10000 (A/0)
02CSET10019 (HI)
04/01/2019
04;01/2019
04/01/2020
04/01/2020
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
X
BODILY INJURY (Per person)
$
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY Per accident
( )
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Per accident
$
X
UMBRELLA LIAB
X
OCCUR
02HUT10021
04/01/2019
04/01/2020
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$ 1,000,000
EXCESS LIAB
CLAIMS -MADE
DED 1 1 RETENTION $
$
C
D
E
E
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? ❑N
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
CT QSI-5565605 (SIR 2.5MM)
CA-012717187
MULTI-12717189, FL-012717188
MULTI-012717185, MULTI-012717186
04/01/2019
04/01/2019
04/01/2019
04/01/2020
04/Ot/2020
04/01/2020
04/01/2020
X PER oTH-
STATUTE ER
E L EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
SEE ACORD 101.
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CONTRACTORS LICENSE
CERTIFICATE HOLDER CANCELLATION
CITY OF FORT COLLINS
P.O. BOX 580
FORT COLLINS, CO 80522
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 3kt.v �.�oo►,: `�'dt"`�L "O1'tic)-`-`-
U 1988-2016 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD