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A� & CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIog)yrrY)
10/01/2019
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(les) 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 certiflcate does not confer rights to the certificate holder in lieu of such endorsements . _. ... ..
PRODUCER
Wiilis Towers Watson, Northeast, Yqc. fka Willis of thew York, Inc.
c/o. 26 Century Blvd
P.O. Box 305191
Nashville, TH 372305191 USA
NAME: CY
NAME:
1-877-945-7378. ,. AX 1-8887467-2378
A!C N
certificates@willie.cael
-ADDRESS:
.INSURER AFFORDING COVERAGE
NAICp
INSURER A: Zurich American Insurance Company
( 16535
_
INSURED
Franklin anorgy service*, LLc'.
1701 Charleston Parkway,
Charleston, SC 29492
INSURERS: American. Guarantee. and Liability Insurance
26267
INSURERC: Arch Insurance company -
I 11150
INSURER O: National Onion rive Inaurance Company of P
19445
INSURER E -
ANSURERF:
CnVERAGFS CERTIFICATE• NUMBER- W13234338 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 PAID CLAIMS.
INSR
L R
... TYPE OF INSURANCE.
A LI
UBR
'REDUCED
POLICY NUMBER
�BY
MINDD/YYFY .
EXP
MM/M/ 01YYY
LIMITS
X
60MMEROALGENERAL LIABILITY
i
EACH OCCURRENCE
S 1, OOOy 000
I CLAIMS -MADE � OCCUR
DAMAGETORENTED
PREMISES (En occurrence
$ 1,000,000
MED. EXP (Any.oneperson)
$ 10,000
A
-
Y
I
CPO 0146471-03
10/01/2019'
09/01/2020
PERSONAL$ ADV,INJURY
$ 1,.060,000
GEN1 AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
I
P 0 U C Y �.. ECa X—'LOC
i
PRODUCTS-. COMFtOP AGG.
$ ?7006,000
$
.I OTHER:
AUTOMOBILE LimmurTY
I
-
INED SINGLE
a accident
$ 1,.000, 000
BODILY INJURY (Per person)
Is
X -I ANY AUTO
I
BODILY INJURY (Per accident)
I $
A
OWNED SCHEDULED
AUTOS ONLY AUTOS-
HIRED NON -OWNED
- AUTOS ONLY AUTOS ONLY
Y
CPO 0146471-03
10/01/2019
09/01/2020
PROPERTY.OAMAGE
a accident
$
$
e
X
UMBRELLA UAB X
EXCESS UAB
OCCUR
CLAIMS -MADE
AUC 0146507-03
10/01/2019
09/01/2020
EACHOCCURRENCE
Is 5,000,000
AGGREGATE
$ 5,000,000
DED X :RETENTION$ 10,000
$
C
WORKERSCOMPENSATION
AND EMPLOYERS' LIABILITY
ANYPROPRIETORIPARTNEPJEXECUTIVE YIN
OFFICERRdEMBEREXCLUDED?
(Myandatory In NH)" "
NIAI
I
LIWCII022000
09/Ol/2019.
09/Ol/2020.-
X STATUTE
ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
$ 1 006, 060
$ 1,000,000
E.L. DISEASE'- POLICY: LIMIT
$ 1 000, 000
describe under
DESC PTION OF OPERATIONS'below
I
D
:Cyber/Professional-Liability --
- -I
01-701-11-72 -
0e/14/2019.
07/01/2020.
Limit:
$10,000,000
DESCRIPTION OF OPERATIONS 1 LOCATIONS i VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached II more space Is required) -
City of Fort Collins in included as additionalinsured under the General Liability, Automobile Liability coverages as
required by written contract.
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.
AUTHORIZED REPRESENTATIVE
City of Fort Collins
PO Box 580
Sort Coiline, CO 80522
y
01198.8-2016 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
GR m: 18613233, BATCH: 1392202
3 0f 3 29159