HomeMy WebLinkAbout105347 ITRON INC - INSURANCE CERTIFICATE (7)� a
AC
`C CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
09n612019
AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
THIS CERTIFICATE IS ISSUED
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
THIS CERTIFICATE_ OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
BELOW.
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
IMPORTANT: If the certificate Holder is an
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 andorsemertt s .
CONTACT
PRODUCER
Marsh USA, Inc.
NAME: -
PHONE F
/c N� c,rt1• C No
1301 5th Avenue. Suite 1900
EMAIL
E-MAIL
Seattle, WA 98101
ADDRESS:
Attn: Seatfle.CertRequest@malsh.com / FAX 212-948-4326
INSURER(5) AFFORDING COVERAGE
_. NAIC$
INSURER A : TraVeerS Property Casually Company Of America
25674
CN102835048-sm4-GAWUE-19-20 GAWU
INSURED
INSURER B : The Travelers Indemnity Company
25658
INSURER C : XL Specialty Insurance Company
37885
Ition,Inc.
Ann: Yvonne Tanak
INSURER D : The Ptwnix Insurance ConM@ny
25623
2111 N. Molter Road
INSURER E : NIA
WA
Liberty Lake, WA 99019-9469
INSURER F
__---------- ._
COVERAGES L rK I Irra pk I c numacn. ..... ___.----- --
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
IN RI
LTR
A I
--�DDL
TYPE OF INSURANCE
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE M OCCUR
R
POLICY NUMBER
6686N12D669-19
POLICY EFF
MM/DDIYYYY
08131019
POLICY EXP
MMIDD
OW112020
LIMITS
EACH OCCURRENCE
It 2,000� ,
PREMISES Ea occurtence
$ 1'0'�
MED EXP (Any one rson)
$ 10,000
PERSONAL &ADV INJURY
$ 2'OD0'000
GENERAL AGGREGATE
$ 4'000'D00
GEN'L AGGREGATE LIMIT APPLIES PER'.
X POLICY n PRO- LOC
JECT
PRODUCTS - COMP/OP AGG
4,000,000
$ _
B
OTHER.
AUTOMOBILE LIABILITY
76219
CAP 1J668-
08131/2019
08/31/2020
COMBINED SINGLE LIMIT
Es accident
7
$ 000.000
_
BODILY INJURY (Per Person)
F—v—1 ANY AUTO
$
BODILY INJURY (Per acadenl)
$
OWNED F7 SCHEDULED
AUTOS ONLY AUTOS
X HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Per accident
$
Comp/Coll Deductible
$ 1,500
X
UMBRELLA LIAR X
EXCESS LIAR
OCCUR
CLAIMS-AMDE
US00086273LI19A
08/3112019
08/31/2020
EACH OCCURRENCE
$ 5'000'000
AGGREGATE
$ 5'000'000
D
UMN023175 (ADS)
1010112020
OTH-
X PTA UTE ER
$
DELI I X I RETENTION$ 10000
WORKERS COMPENSATION
E.L. EACH ACCIDENT
$ 1,000,000
AND EMPLOYERS' LIABILITY YIN
ANYPRA
OFFICER/MEMBE) EXCLUDED?
OFFICE IMEMB REXC EXCLUDED? O
(Manliatcry in NM)
If yes, desadie under
DESCRIPTION OF OPERATIONS below
N!A
UB-8N033212 I, MA, NE
(WI, )
10101/2019
10101/2020
E.L. DISEASE • EA EMPLOYE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more apace is required)
The City of Fort Collins, its officers, agents and employees shall be named as additional insureds as it relates to general and auto liaollitY in accordance with the terms and conditions of the policies 30 day notice of
cancellation except for non payment of 10 days.
City of Fort Collins
City Clerk
PO Box 580
Fort Collins, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEL{'VERED IN
ACCORDANCE'WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
of Marsh USA inc.
Peggy Boren f6vii
•=.. n 11 �MMAOAYInM All.,- K+c Irma NOII
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD