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Home My WebLink About476648 NOVAK CONSULTING GROUP - INSURANCE CERTIFICATEAC"J?H CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 04/24/2019 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 CONTACT Lisa Ernst NAME: Dempsey & Siders Agency Inc. aCC' o (513) 936-4110 q/C, (513) 891-4281 Ext : No : 6725 Miami Avenue, Suite 102 E-MAIL lernst@dempsey-siders corn ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # Cincinnati OH 45243-3158 INSURER A : y Ohio Security Insurance Cc 24082 INSURED INSURER B: y Ohio Casualty Insurance Co. 24074 The Novak Consulting Group INSURER C : Travelers Casualty & Surety Company of Amercica 31194 26 E Hollister Street INSURER D : INSURER E : Cincinnati OH 45219 INSURER F: COVERAGES CERTIFICATE NUMBER: 19-20 GL/Auto/Umb/WC 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 MAYBE 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 AUDL INSD SUEIK WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 15,000 PERSONAL & ADV INJURY $ 1,000.000 A Y Y BKS57930444 04/01/2019 04/01/2020 GEN'LAGGREGATE X LIMIT APPLIES PER PRO- JECT LOC GENERAL AGGREGATE g 2,000,000 PRODUCTS-COMP/OPAGG 2,000,000POLICY $ $ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANYAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS Y Y BAS57930444 04/01/2019 04/01/2020 BODILY INJURY (Per accident) $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY X PROPERTY DAMAGE Per accident $ X $ HAPD X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000 AGGREGATE g 3,000,000 B EXCESS LIAB CLAIMS -MADE US057930444 04/01/2019 04/01/2020 DED I X1 RETENTION $ 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? a NIA XW057930444 04I01/2019 04/01/2020 X1 STATUTE EORH Employers Liability E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1 000,000 C Professional Liability & Cyber Liability 105589049 04/01/2019 04/01/2020 Each Claim Aggregate 2,000,000 3,000,000 Retention 5,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 1.1, Additional Remarks Schedule, may be attached if more space is required) As required by written contract, the City of Fort Collins is named as Additional Insured on a Primary Non -Contributory basis with Waiver of Subrogation in regards to General Liability per CG8810(04-13), CG2010 and CG2037 as well as Auto Liability with Waiver of Subrogation per CA8810(01-10) to the extent provided in these forms. Umbrella Follows Form. astv�r�z�i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. R 0 Box 580 AUTHORIZED REPRESENTATIVE Fort Collins CO 80522 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD