HomeMy WebLinkAboutCORVEL CORPORATION - INSURANCE CERTIFICATEAco CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
04/25/2019
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).
CONTACT
PRODUCER NAME__
MARSH USA INC. PHONE FAX
540 W. MADISON IA/C No ExU; _ FAX
No):
CHICAGO, IL 60661 E-MAIL
Attm chicago.CertRequest@marsh.com ADDRESS:
INSURER(SI AFFORDING COVERAGE NMC #
INSURER A: Travelers Property Casualty Company of America 25674
INSURED INSURER B : N/A WA
CorVel Corporation
Attn: Jay Villeda INSURER C : N/A _ N/A
2010 Main Street, Suite 600 INSURER D :
Irvine, CA 92614
INSURER E :
INSURER F :
/1C0TIC1f`AT0 A11111ACCC• ('HI-f1fIQlgFii3ii-rls RFVISInN NIIMBFR- 3
vTHIS 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/DDIYYYY
POLICY EXP
MM/DD/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
TJGLSA28OK5095TIL19
04/30/2019
04/30/2020
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE OCCUR
DAMAGE TO 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
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
POLICY ❑ PRO LOC
JECT
OTHER
AUTOMOBILE LIABILITY
O MB, airCNdEeDtSINGLE LIMIT
COMB
$
BODILY INJURY (Per person)
$
ANY AUTO
BODILY INJURY (Per accident)
$
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Per accident
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$ _
EXCESS LIAR
CLAIMS -MADE
DED RETENTION $
$
WORKERS COMPENSATION
PER OTH-
STATUTE ER
AND EMPLOYERS' LIABILITY YfN
ANYPROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
OFFICER/MEMBER EXCLUDED? ❑
(Mandatory in NH)
N / A
E.L. DISEASE -POLICY LIMIT
$
If yes, describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
City of Fort Collins is included as Additional Insured under the General Liability policy as their interest may appear, but only to the extent such status is required under their written contract / agreement with the Name(
Insured.
GLK 1 IFIGA I L HULULK r�lw� a tee+ 1 wn
City of Fort Collins
ATTN: Gerry Paul
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
l) T`Jtf O-LU10 At.UKLP liVRr•VRA I IVIY. 1111 r1!J11W rCAWIVWu.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD