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HomeMy WebLinkAboutCIGNA CORPORATION ET AL - INSURANCE CERTIFICATE.4f✓!20 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 06/25/2019 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). PRODUCER Aon Risk Services Central, Inc. Philadelphia PA Office CONTACT NAME: (A/CO.NNo. Ext): (866) 283-7122 FAX No.): (800) 363-0105 E-MAIL ADDRESS: One Liberty Place 1650 Market Street INSURER(S) AFFORDING COVERAGE NAIC # suite 1000 Philadelphia PA 19103 USA INSURED INSURER A: ACE American Insurance Company 22667 Cigna Corporation Et Al INSURER B: 900 Cottage Grove Road Bloomfield CT 06002 USA INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570077052621 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 ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDYYY M/ MDDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY HDOG /ZU'977/ EACH OCCURRENCE $1,000,000 CLAIMS -MADE X❑ OCCUR DAMA E(RENTED PREMISESS Ea occurrence $1 000 000 MED EXP (Any one person) $ 5 , 000 PERSONAL &ADV INJURY $1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER GENERAL AGGREGATE $3,000,000 X POLICY ❑ PRO ❑ JECT LOC PRODUCTS - COMP/OPAGG $1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED tSINGLE LIMIT Ea acciden BODILY INJURY ( Per person) ANYAUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGE Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE AGGREGATE EXCESS LIAB CLAIMS -MADE DED RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR PARTNER, EXECUTIVE PER OTH- STATUTE ER E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? ❑ N / A E.L. DISEASE -EA EMPLOYEE (Mandatory in NH) If vesdescribe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Named Insured Includes: Cigna Health and Life Insurance Company, 900 Cottage Grove Road, Bloomfield, CT 06152. The City of Fort Collins, its officers, agents and employees are included as Additional insured in accordance with the policy provisions of the General Laibility and Automobile Liability policies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins AUTHORIZED REPRESENTATIVE 215 North Mason Street Fort Collins CO 80524 USA �Y-Xo�L c ���sGS4t�D l��EyayGt� e✓ �2cL ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD