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HomeMy WebLinkAbout580920 LAMP RYNEARSON & ASSOCIATES - INSURANCE CERTIFICATE (2)k - CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYY1') 9/24/2019 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 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 The Harry A. Koch Co. vrHONE - FAX P.O. Box 45279 402-861-7000 LAIC, No). Omaha NE 68145-0279 ADDRES : INSURER AFFORDING COVERAGE J NAIC# INSURERA: XL SDecialtv Insurance Co 1 37885 INSURED INSURERB: The Phoenix Insurance Co Lamp Rynearson, Inc. 4715 Innovation Drive INSURERC: Travelers Property Casualty of Suite 100 INSURER D: Travelers Indemnity Company Fort Collins CO 80525 COVERAGES CERTIFICATE NUMBER: 1050331017 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. INSR LTR I rypE OF INSURANCE ADDL BR POLICY NUMBER POLICYEFF M POLICY EXP MMIDDM/W LIMITS B X COMMERCIAL GENERAL LIABILITY 66021-971185 9/30/2019 9/30/2020 EACH OCCURRENCE $1,000,000 CLAIMS -MADE a OCCUR PREMISES Ea accunence $ 500,000 MED EXP (Any oneperson) $ 10,000 PERSONAL BADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE GEN'L s2,000,000 POLICY [X] JET LOC $2,000,000 PRODUCTS-COMP/OP AGG --_5 OTHER. C AUTOMOBILE LIABILITY 81021-974010 9/30/2019 9/30/2020 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) X ANY AUTO $ OWNED SCHEDULED AUTOS ONLY AUTOS $ er accident) BODILY INJURY (Per PROPERTY DAMAGE Ler acchaent HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ $ C X UMBRELLA LIAB X OCCUR CUP31-015816 9/3012019 9/30/2020 EACH OCCURRENCE $5,000. coo AGGREGATE EXCESS LIAB CLAIMS -MADE 11000 DIED -' X I RETENTIONS in nnn 1 1 $ D WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ^NYPROPRIETOR/PARTNER/EXECUTIVE USSM96WS2 9/30/2019 9/30/2020 IX I STATUTE I I ERH _ $500,000 E.L. EACH ACCIDENT OFFICERIMEMBEREXCLUDED7 a NIA - E.L. DISEASE -EA EMPLOYEE (MandalarylnNH) $500,000 tt yyes, oesmbe under DESCRIPTION OF OPERATIONS belowL $ 500.000 E.L. DISEASE - POLICY LIMIT A Arrhitects/Engineem DPR9949116 9/30/2019 9130/2020 $5.000,000 EB.Claim Professional Liability Claims Made Basis $5.000.000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may W attached if more space is required) The City of Fort Collins is additional insured for auto liability and general liability if required by written contract executed prior to loss. l:ttt I IFII:A I t The City of Fort Collins Purchasing Department PO Box 580 Fort Collins CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHO DREPRESEENTAATTTIIIV; ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD