HomeMy WebLinkAboutALLIED UNIVERSAL TOPCO LLC - INSURANCE CERTIFICATEACC CERTIFICATE OF LIABILITY INSURANCE
D M1/20019
THI�RTIFICATE 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 pci tcy(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 endorsements .
PRODUCER
MARSH USA INC
1717 Arch Sheet
Philadelphia, PA 19103
Ann: Philadelphia.terts@marsh.com / Fax: (212) 948-0360
C -
NAME:
PHONEFAX
.
AIC No
ADD IL
INSURE S AFFORDING COVERAGE
NAICi
INSURER A:Lexington Insurance Company
19437
CN11W25105-AUS,GAWU-19.20
INSURED Allied Universe] Topce, L-C;
(See Attached for Additional Named Insureds)
161 Washington Sheet, Suite 600
Conshohocken, PA 19428
INSURER B: Greenwich Insurance Company
22322
INSURER C : XL Insurance America
24r
INSURER D : Indian Harbor Insurance Company
36940
INSURER E : XL Insurance Company
37885
INSURER F :
i.�.' ..nee /`cGY1e11-ATC WnMnFG. N F.0116354117-04 REVISION NUMBER: U
THIS IS TO CERTIFY THATTHE_ 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
TYPE OF INSURANCE
AD L
U
POLICY NUMBER
M DPOLICY EFF
POLICY EXP
MIDDAMY
LIMITS
A
X
COMMERCIAL GENE RAIL LIABILITY
CLAIMS -MADE FRI OCCUR
CONTRACTUAL LIABILITY
082695264
11/01/2019
11/01/2020
EACH OCCURRENCE
$ io,op'm
PREMISES (Ea occurrence)
$ 10,000,D00
X
MED EXP (Any one
$
X
SIR $1,750,000
PERSONAL s ADV INJURY
$ 10,000,000
GEN'L AGGREGATE. LIMIT APPLIES PER:
X PRO ❑ LOC
POLICY ❑ JECT
OTHER:
GENERALAGGREGATE
$ 10,000,000
PRODUCTS-COMP/OP AGG
$ 10,0D0,000
B
AUTOMOBILE LIABILITY
X ANY AUTO AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
RAD9437818-03
1110112019
11/01/2020
OMBBIINEDtSINGLE LIMIT
Me acciden
$ 5,006,600
BODILY INJURY (Per person)
S
BODILY INJURY (Per accident)
$
PROPERTYDAMAGE
Per acdoent
-
$
$
UMBRELLA LIAS
EXCESS LIAR
X
OCCUR
CLAIMS -MADE
RES9437994
EXCESS OF GENERAL LIABILITY
-
11/0112019
11/01/2020
EACH OCCURRENCE
$ 10,000,000
X
AGGREGATE
$ 10,006,000
DED RETENTION S
$
WORKERS COMPENSATION
AND EMPLOYERSLIABIUTY YIN
ANYPRE
OFFICE IMEMB REXC UDED?ECUiIVE E
OFFICE ory In NH),
(Mandatoryln NH)
If describe uncle
DESCRIPTION OF OPERATIONS below
NIA
RWD3D01203-03(AOS)
RWR3001204-03(WI)
-
11/01/2019
1110112_020
-
11/01/2020
FE_
X STATUTE ERH
E.L. EACH ACCIDENT
$ 1,0W'000
E.L. DISEASE - EA EMPLOYEE
$ 1,OOD,000
E.L. DISEASE - POLICY LIMIT
1,000,000
$ -
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD lot, Additional Remarks Schedule, may be anaUied if more space Is required)
Certificate Holder is included as additional insured where required by written contract with respect to General Liability and Auto Liability.
City of Fort Collins
Purchasing Department
P.O. Box 280
Ft Collins, CO 805N
SHOULD ANY OF THE ABOVE' DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
of Marsh USA Inc.
Manashi Mukherjee MauaeJ w►
reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD