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HomeMy WebLinkAboutRAY VIGER SERVICES - INSURANCE CERTIFICATE (2)AC DATE (MMIDDNYYY) CERTIFICATE OF LIABILITY INSURANCE 09/04/2019 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 be endorsed. If SUBROGATIONIS 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 NAME: AUTOMATIC DATA PROCESSING INS AGCY 76250717 PHONE (877) 287-1316 (A/C, No, Ert): FAX (888) 443-6112 (AIC, No): 71 HANOVER ROAD FLORHAM PARK NJ 07932 EMAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAICO INSURERA: Twin City Fire Insurance Company 29459 INSURED INSURER e : Hartford Accident and Indemnity Company 22357 RAY VIGER SERVICES INSURERC: 2881 S BROADWAY ENGLEWOOD CO 80113-1524 Insuluat o INSURER E : INSURER F : rnVFRAr7FS rFRnt:ICATF NIIMRFR- 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.NOTWITHS TANDING 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 INSR SUER POLICY NUMBER POLICY EFF IMMfQO[YyYY1 POLICY EXP ?MMIDDry YYY1 LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS -MADE -OCCUR DAMAGE TO RENTED nc PREMISES Eu $1.000.000 MED EXP (Any one Person) $10,000 X General Liability A 76 SBW BF8218 08/23/2019 08/23/2020 PERSONAL BADV INJURY $1,000.000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 POLICY ❑ PRO- ❑ LOC X JECT PRODUCTS-COMP/OP AGO $2,000.000 OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT r $1 000 000 BODILY INJURY (Per person) ANY AUTO A ALL OWNED SCHEDULED AUTOS AUTOS 76 SBW BF8218 08/23/2019 08/23/2020 BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) HIRED NON -OWNED X AUTOS X AUTOS UMBRELLA UAB X OCCUR EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 EXCESS MADE 76 76SEWBF8218 08/23/2019 08/23/2020 ED X I RETENTION $ 10,000 WORKERS COMPENSATION PER X OTH- AND EMPLOYERS' LU1eILITY STATUT- ER E.L EACH ACCIDENT $1,000,000 ANY YIN B PROPRIETORlPARTNERIEXECUTIVE OFFICER/MFM13ER EXCLUDED? NIA 76 WEG AD9BB5 08/23/2019 08/23/2020 E.L. DISEASE -EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes. describe under E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below A EMPLOYMENT PRACTICES LIABILITY 76 SBW BF8218 08/23/2019 08/23/2020 Each Claim Limit Aggregate Limit $10,000 $10,000 DESCRPTXM OF OPERATIONS /LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. rCOTICIr ATF un1 nFR ICANCFI I AT7oN City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED PO BOX 580 BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED FORT COLLINS CO 80522 IN ACCORDANCE WrrH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE d;e'6 .J of C�zz-zz� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD