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HomeMy WebLinkAboutEVERLAST CLIMBING INC - INSURANCE CERTIFICATEACORO� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) O8i0212019 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 Marsh USA, Inc. NAME: Two Alliance Center jAlC No Exec AX C No . _ 3560 Lenox Road, Suite 2400 EMAIL Atlanta. GA 30326 ADDRESS: Alm: Atanta.CeRRequest@marsh.com/Fax. 212-948-4321 INSURERS) AFFORDING COVERAGE CN102326389-Everl-GAUWX-19-20 INSURER A: Evanston Insurance Corriparry35378 INSURED INSURER B : The Travelers Indemnity Company of America 25666 Evedast Climbing, Inc Attention. Mara Townson INSURER c : ACE Property And Casualty Ins Co 20699 42 Northern Stacks Drive INSURER D : Travelers Property Casualty Company Of America 25674 Suite 100 Minneapolis. MN 55421 INSURER E : National Union Fire Ins Co. of Pittsburgh PA 19445 COVERAGES CERTIFICATE NUMBER: ATL-004838641-07 REVISION NUMBER: 2 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 A DL U R POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYY LIMITS A X COMMERCIAL GENERAL LIABILITY MKLV2PBC000367 08/0112019 08/01/2020 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE I--Lxl OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 X MED EXP (Any one person) $ EXCLUDED SIR $50,000 Per OCC. PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 4,000,000 P� jE � OLICY LOC PRODUCTS - COMP/OP AGG $ 4,000,000 POLICY AGGREGATE $ 10,000,000 OTHER D AUTOMDBILELIABIUTY TJ-CAP-9D897065TIL-19 08/0112019 08/01/2020 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Par person) $ AINY AUTO OWNESDONLY TOS SCHEDULED AU AUTO BODILY INJURY (Per accident) $ PROPERTYDAMAGE Par accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Comp/Coll [led: $1,000 $ X I UMBRELLA LIAB X OCCUR XOOG71549501001 08/01/2019 08/01/2020 EACH OCCURRENCE $ 10,000,000 ElEXCESS AGGREGATE $ 10,000,000 UAB CLAIMS -MADE DIED I X I RETENTIONs2S000 $ I F D WORXERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH) NIA UB-2N106953-19.51-R UB-2N159031-19.51-K UB-7J602089-19-14-G 08/0112019 08/01/2019 8 / 08/01/2020 08/0112020 XPER OTH- STATUTE I ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 It yes, describe under(See DESCRIPTION OF OPERATIONS below Additional Page.) E.L. DISEASE - POLICY LIMIT $ 1.000.000 E Excess Umbrella BE 015899319 08/0112019 08/01/2020 Each Occurrence 15,000,000 Aggregate 15.000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) RE Quotation # QTE-00043730-5 - Supply of Bike Rails and Racks - FC Bikefrransportafion Planning City of Fort Collins, its officers. officials, agents, and employees are listed as additional insured as their interests may appear during and until completion of the supply of materials, on a primary and non-contributory basis, on the General Liability via CG 2010 and Automobile Liability via CA T4 37 policies, when required by written contract. A Waiver of Subrogation applies in favor of the additional insureds on the Workers Compensation policy, when required by written contract. CERTIFICATE HOLDER CANCELLATION City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO Box 580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Fort Collins. CO 80522 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherlee _M.n^.n.r+o ti•.�A^.�[t nud<a. ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD