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HomeMy WebLinkAboutMORTON BUILDINGS INC - INSURANCE CERTIFICATE (3)�1 ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) D9/DBM2D,9 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. Chicago IL Office CONTACT AME: NPHOAX (A/C.NNo. Ext): (866) 283-7122 (A/C. No,); (800) 363-0105 E-MAIL ADDRESS: 200 East Randolph Chicago IL 60601 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Great American Insurance company Of NY 22136 Morton Buildinqs, Inc. INSURER B: Zurich American Ins CO 16535 252 West Adams Street Morton IL 61550 USA INSURER C: American Zurich Ins Co 40142 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 57U0/8189564 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 INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/VYYY IMWDDIYYYYI1LIMITS B X COMMERCIAL GENERAL LIABILITY GLO EACH OCCURRENCE $2,000,000 CLAIMS -MADE X❑DCGUR DAMAGE To RMT1`1715-- PREMISES Ea occurrence)$1,000,000 MED EXP (Any one person) $50 , 000 PERSONAL &ADV INJURY $2,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $10,000,000 X POLICY ❑ PRO ❑ LOC JECT PRODUCTS - COMP/OPAGG Excluded OTHER: B AUTOMOBILE LIABILITY BAP 9376314 16 10/01/2019 10/01/2020 COMBINED SINGLE LIMIT Ea accident $2,000,000 BODILY INJURY (Per person) X ANY AUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HIRED AUTOS NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGE Per accident A X UMBRELLALIAB X OCCUR UMB3161421 10/01/2019 10/01/2020 EACH OCCURRENCE $2,000,003 EXCLIAR CLAIMS -MADE umbrella Liability SIR applies per policy terns & condi ions AGGREGATE $2,000,000 lESS ED X RETENTION C B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR PARTNER I EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? F;] (Mandatory in NH) NIA WC937631116 ADS WC937631216 Retro MA,WI 10/01/2019 10/01/2019 10/Ol 2020 10/01/2020 X PER OTH. STATUTE ER E.L. EACH ACCIDENT $1,000.000 EL DISEASE -EA EMPLOYEE $1,000,000 Nunder DESCRIPTION under DESCRIPTION OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Contractors License. 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 P.O. Box 580 Fort Collins, CO 80522-0580 USA cJL�/C e./stueed (�bnL�aG c/�aeL ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD