HomeMy WebLinkAbout553887 CRORY & ASSOCIATES INC - INSURANCE CERTIFICATECROR&AS-01 LBARNHARI
ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
4/26/2019
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 CNRAJCT
Placer Insurance Agency
5 Sierra Gate Plaza 2nd FI PHONE
, EXt): (916) 784-1008 (A/C, No):(916) 784-8116
Roseville, CA 95678 5 - — -
INSURED
Crory & Associates, Inc.
Rick Crory
901 Sunrise Ave, Ste B-12
Roseville, CA 95661-4560
INSURER F :
Ltd. 111000
rnVFRA(_FS rFRTIFIrATF NIIMRFR• RFVISInN NIIMRFR-
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 I LTR TYPE OF INSURANCE IADDL
NSD SUBR POLICY NUMBER POLICY EFF POLICY EXPMIDDLIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
Tech E&O $3,000,000
X
57SBARH6288
5/9/2019
5/9/2020
EACH OCCURRENCE
2,000,000
DAMAGE TO R(EaENTISE$ currence
1,000,000
X
MED EXP (Any oneperson)
$ 10,000
PERSONAL & ADV INJURY
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY t '" LOC
OTHER:
GENERAL AGGREGATE
$ 4,000,000
PRODUCTS - COMP/OP AGG
41000,000
B
AUTOMOBILE LIABILITY
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
SSyy Ep
AUTOS ONLY AUTOS ONNLV
X
57UECZC7339
5/9/2019
W9/2020
COMBINED SINGLE LIMIT
1,000,000
$
S
BODILY INJURY Per coon
BOODILY INJURY Per accident
4OacEcCent4ANIAGE
A
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
57SBARH6288
5/9/2019
5/9/2020
EACH OCCURRENCE
AGGREGATE
$ 1,000,000
$ 1'000'000
DIED I X I RETENTION $ 10,000
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN7R
ANY PROPRIETOR/PARTNER/EXECUTIVE
FILER, in, b;Eg'R' EXCLUDED? i _-
andry NH)
�ato
If yes, describe under
DESCRIPTION OF OPERATIONS below
N A
�
O
$
$ - --
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYE
E.L. DISEASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
The City of Fort Collins, its officers, agents and employees are included as additional insured with respects to general liability per attached SS0008 0405
endorsement and auto liability per attached HA 99 16 03 12 endorsement.
rrooTtctrerc unt nco rAldrl=l I ATInN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins
ty
ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Purchasing Dept
PO Box 580
AUTHORIZED REPRESENTATIVE
Fort Collins, CO 80522
P
ACORD 25 (2016/03) 01988-2015 ACORD CORPORATION. All rights reserved.
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