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HomeMy WebLinkAbout661511 ADVANCED CONTROL SYSTEMS INC - INSURANCE CERTIFICATE (2)Client#: 1725844 INDRAUSA ACORD CERTIFICATE OF LIABILITY INSURANCE DATE MM;DDYYYY) 8/20/2019 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 pollcy(les) 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAMNT EACT Linda Rolfe Cameron M Harris & Co, LLC aCNo �,980-265-5804 AAX No): Div USI Ins AFL$ linda.rolfe@usi.com Charlotte, Fairview Road Ste 1400 INSURER(S) AFFORDING COVERAGE I NAIc# ChaHOtte, NC 28210 INSURER A : AIG Specraiy Insur en company 26883 INSURED Advanced Control Systems, Inc. 2755 NorthwoodsPkwy Peachtree Corners, GA 30071 COVERAGES CERTIFICATE NUMBER: B ; Valley Forge Insurance company LUDNAtf C ; Lloyd's syndicate NZI (Bea:ley Fudorte NONAIC D ; Nadoml Union Fin, Ma Pataburah, PA 19445 E : commerce & Industry Insurance Co. F: 19410 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 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. MR LTR TYPE OF INSURANCE ADDL INSR SUORPOLICY )Onto POLICY NUMBER EG24205501 EFF POLICY EXP (MMIDDN= LIMITS A X COMMERCIAL GENERAL LIABNm CLAIMS-MADED CLAIM MADE OCCUR _(MM/DD/YYYY) 3/03/2019 03/03/2020 EACH $11000,000 �OCCURRENCE PREdMIBES Ea occurrrence) s300 000 MED EXP Any one person) $ 2$ 000 PERSONAL & ADV INJURY $1 000 WO GEML AGGREGATE LIMIT APPLIES PER: PRO - POLICY MI JECTT F7 LOC OTHER: GENERAL AGGREGATE $2 OOO OOO PRODUCTS - COMP/OP AGG s2,000 000 $ E AUTOBIOSILE LIABILITY ANY AUTO AUTOS ONLY NED i SCHEDULED AUTOS X WNED AUTOS ONLY X AUTp ONLYY CA3962352 3/03/2019 03/03/2020 COMBINED SINGLE LIMIT a ac 'den 110001000 BODILY INJURY (Per person) $ BODILY INJURY Per accident ( ) $ Parr Pa EuR�rsDAMAGE $ $ A UMBRELLA LIAB OCCUR EXCESS LIAB X CLAIMS -MADE DE D RETENTION$ EGU24205502 3/03/2019 03/03/202 EACH OCCURRENCE $10 000 000 X AGGREGATE $1 O 000 000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? a (Mandatory In NH) yes. describe under DESCRIPTION OF OPERATIONS below N/A 6076016113 3/03/2019 03/03/202 OTH- 051—AlTuTE E.L. EACH ACCIDENT $1 OOO OOO E.L. DISEASE - EA EMPLOYEE $1 OOO owIf E.L. DISEASE - POLICY LIMIT $1,000 D00 $3,000,000 $2,000,000 C D Technology E&O Tech. E&O Excess W243A2190201 017018192 8/21/2019 08/21/2020 8/21/2019 08/21/2020 DESCRIPTION OF OPERATIONS LOCATIONS VEHICLES (ACORD 101, Additional Remarks Schedule, may be anached if more space is red uired) The General Liability and Automobile Liability policies include an automatic additional insured endorsement that provides additional insured status to The City, its officers, agents and employees, only when there is a written contract that requires such status, and only with regards to work performed on behalf of the named insured. City of Fort Collins 300 LaPorte Avenue Fort Collins. CO 80521-0000 LLH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) 1 of 1 #S26397362/M26393616 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BYPZP