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EL DORADO NATIONAL (CALIFORNIA) INC - INSURANCE CERTIFICATE (2)
,acofZ�' CERTIFICATE OF LIABILITY INSURANCE 11/1/2019 DATE(MM/DD/YYYY) 1 6/27/2019 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 Lockton Companies Three City Place Drive, Suite 900 St. Louis MO 63141-7081 (314) 432-0500 CONTCT NAMEA NE AX Ext : A/c, No : L E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: Great American E & S Insurance Company 37532 INSURED El Dorado National (California), Inc. 1422419 9670 Galena Street Riverside CA 92509 INSURER B: Travelers Property Casualty Co of America 25674 INSURER C : AXIS Surplus Insurance Company 26620 INSURER D : INSURER E : INSURER F : COVERAGES ALLSP CERTIFICATE NUMBER: 14499744 REVISION NUMBER: XXXXXXX 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP (MMIDDfYYM LIMITS A X COMMERCIAL GENERAL LIABILITY Y N PL1744639-02 7/1/2019 11/1/2020 EACH OCCURRENCE 1,000,000 CLAIMS -MADE x OCCUR PREMISESa oceu ante 300000 MED EXP (Any oneperson) XXXXXXX PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY❑ JECOT- LOC GENERAL AGGREGATE $ 4,000,000 PRODUCTS -COMP/OP AGG $ 4,000,000 1 $ OTHER: B AUTOMOBILE LIABILITY Y N TC2J-CAP-8E082581-TIL-19 7/l/2019 11/1/2020 (Ea EI SINGLE LIMIT $ 1,000,000 X BODILY INJURY (Per person) $ XXXXXY_X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS I BODLY INJURY Per accident ( $ XV�YiJVI X PROPERTY DAMAGE Per accident $ XXXXXXX HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $XXXXXXX C UMBRELLA LIAB NOCCUR N N P-001-000123735-01 7/1/2019 11/1/2020 EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ XXXXXXX B B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N OFFICEANYPROPRIET ER EXCLUDED? ECUTIVE (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A N TC2JUB-118D4882-19 (AOS) TRJUB-118D4901-19 (AZ,MA, TWXJ-UB-8E082206-19 (OH) 7/1/2019 1/2019 /1/2019 11/1/2019 11/1/2019 11/1/2019 PER OTH- X STATUTE HER E.L. EACH ACCIDENT $ 1 000 000 E.L. DISEASE - EA EMPLOYEE 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 B Garage Keepers Liability N N TC2J-CAP-8E082581-TIL19 7/1/2019 11/1/2020 Blanket $5,000,000 by location DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CITY OF FORT COLLINS IS ADDITIONAL INSURED UNDER THE GENERAL LIABILITY AND AUTOMOBILE LIABILITY AS REQUIRED BY WRITTEN CONTRACT. THE INSURNACE EVIDENCED BY THIS CERTIFICATE WILL NOT REDUCE COVERAGE OR LIMITS AND WILL NOT BE CANCELLED, EXCEPT AFTER THIRTY (30) DAYS WRITTEN NOTICE HAS BEEN RECIEVED BY THE CITY OF FORT COLLINS. CERTIFICATE HOLDER CANCELLATION See Attachment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 14499744 AUTHORIZED REPRESENTATIVE CITY OF FORT COLLINS 215 NORTH MASON STREET FORT COLLINS CO 80524 ACORD 25 (2016/031 ©1988- CORD CO ORA N. All rights reserved The ACORD name and logo are registered marks of ACORD