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ADT LLC DBA PROTECTION ONE - INSURANCE CERTIFICATE
AC40 CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDlYYYY) 09/27/2019 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 Marsh USA Inc. NAME: "E' ' PHONE LAIC No Ex= 1560 Sawgrass Corporate Pkwy. Suite 300 EMAIL -- Sunnse,FL 33323 Attn: FtLauderdale.Certs@marsh.com ADDRESS: INSURER(S) AFFORDING COVERAGE INSURER A : Dld Re UbIic Insurance Co CN109418288-ADT-GAW-19-20 _ _ INSURED ADT LLC dba Protection One INSURER B : — - - INSURER C : 7808 Cherry Creek South Drive, Suite 113 Denver, CO 80231 INSURER D : COVERAGES CERTIFICATE NUMBER: ATL-004399374-10 REVISION NUMBER: 0 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTH STANDING 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 OF INSURANCE ADDLTYPE INSD SUER POLICY NUMBER MM/DDPOLICY /VYVYl (MWDDfYYYYI LIMITS A` X COMMERCIAL GENERAL LIABILITY MWZY 31431819 10101/2019 10/0112020 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE Fx_] OCCUR DAMAGE TO RENTED PREMISE Ea occurrence $ 1,000,000 X MED EXP (Any oneperson) $ 10,000 SIR: $500,000 X Professional Liab Included PERSONAL S ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 4,000,000 X POLICY PRO JEC7 DUCTS ODUCTS - COMP/OP AGG PRO S 4,000,000 $ OTHER A AUTOMOBILE LIABILITY MWiB 31431919 10/01/2019 10/0112020 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO DIVINESCHEDULED AUTOS AUTOS SCHEDULED BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY v r N OFFIC RIMEMBER EXCLUDED? ECUTIVE I (Mandatory in NH) NIA MWC 31431719 10/0112020 X IPER OTH- STATUTE ER I E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 If yes describe urger DESCRIPTION OF OPERATIONS below E.L.DISEASE - POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached 1t more space is required) Prolessional Liability is Included under the General Liability policy subject to the policy provisions. City of Fort Collins 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. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Masashi Mukherlee 6" _JA "_t'" '4 © 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD