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HomeMy WebLinkAboutRFI INTERNATIONAL - INSURANCE CERTIFICATE,4 �® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YWY) 05/31/2019 I 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 AOn Risk services South, Inc. Charlotte NC Office CONTACT NAME: (aC.NNo. Ext): <866) 283-7122 jvc. No.): (800) 363-0105 E-MAIL ADDRESS: 1111 Metropolitan Avenue, suite 400 Charlotte NC 28204 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Lloyds syndicate No. 2623 AA1128623 RTI International 3040 Cornwallis Rd PO Box 12194 INSURER B: National Fire Ins. Co. of Hartford 20478 INSURERC: Continental Casualty Company 20443 Research Triangle Park NC 27709-2194 USA INSURER D: Valley Forge Insurance Co 20508 INSURERE: The Continental Insurance Company 35289 INSURER F: COVERAGES CERTIFICATE NUMBER: 570076450904 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 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. Limits shown are as requested LTR TYPE OF INSURANCE NSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS C X COMMERCIAL GENERAL LIABILITY 4 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X❑ OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $1,000,000 MED EXP (Any one person) $15 , 000 PERSONAL &ADV INJURY $1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY ❑ PRO JECT � LOC PRODUCTS - COMP/OP AGG $2,000,000 OTHER: B AUTOMOBILE LIABILITY 4034978456 06/01/2019 06/01/2020 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY ( Per person) ANYAUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED ONLY AUTOS ONLY IXX PROPERTYDAMIAGE Per accident $1,000 Coll Ded X $1,000 Comp Deo UMBRELLA LIAB EACH OCCURRENCE AGGREGATE EXCESS LIAB HOCCUR CLAIMS -MADE DED RETENTION E B D WORKERS ORKE SCOMPENSATION AND YIN ANY PROPRIETOR / PARTNER I EXECUTIVE OFFICER/MEMBER EXCLUI (Mandatory in NH) N / A 4034978361 4034978215 4034978151 06/01/2019 06/01/2019 06/01/2019 06/01/2020 06/01/2020 06/01/2020 X SPER TATUTE EORH 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 A E&O-MPL-Primary w1B95B190401 06/01/2019 06/01/2020 Each Claim $1,000,000 E&O Claims Made Aggregate Limit $1,000,000 SIR applies per policy terms & condi ions DESCRIPTION OF OPERATIONS / LOCATIONS / 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 in accordance with the policy provisions of the General Liability and Automobile Liability policies. CERTIFICATE HOLDER CANCELLATION Y� �a SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. The City Of Fort Collins, CO AUTHORIZED REPRESENTATIVE Attn: Purchasing Department �I Po Box 580 Fort Collins CO 80522 USA �rrrA���ccc cCJJ/ ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD