HomeMy WebLinkAbout144217 CCMSI HOLDINGS INC - INSURANCE CERTIFICATE (11)CERTIFICATE
CCMSHOL-01
LIABILITY INSURANCE I DATE(IA1911YYYY)
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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 CgNSITITUTE 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 WANED, subject to the to... and conditions of the policy, certain policies may req ilre an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endoreement(s).
PRODUCER
Mesirow Insurance Services, Inc.
353 N Clark St IIth Floor
Chicago, IL 60654
INSURED
CCMSI Holdings, Inc
2 East Main Street, Suite 208
Towne Centre Building
Danville, IL 61832
F:
595-6200
......�e.n�� recVICIrAV= MY1a1191e0• I REVISION NUMBER:
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THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE
BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXOLUSIONS AND CONDITIONS OFSUCHPOLICIES. LIMITS SHOWN MAY
HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
TYPE OF INSURANCE
ADD
INS
SUBIR
POLICY
I
NUMBER
.POLICY EFF
.POLICY EXP
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
1,000,000
CLAIMS -MADE ❑X OCCUR
X
6079556217
11/17/2019
11/17/2020
DAMAGE TO RENTED
-
$ 100,000
MED EXP. An one rson
15,000
PERSONAL & ADV.INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY ❑ PRO ❑ LOC
JECT
. GENERAL AGGREGATE
2,000,000
PRODUCTS - COMP/OP AGG
2,000,000
EE Benefits
1,000,000
OTHER :
B
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
I,000,000
-
BODILY INJURY Per arson
_
X ANYAUTO
X
6079556220
11117/2019
'11Y17/2020
BODILY INJURY Per acddeM
OWNED SCHEDULED
AUTOS ONLY AUTOS
X HIRED X NONOWNED
AUTOSONLY AUTOS ONLY
PROPERTY DAMAGE
_
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE.
.AGGREGATE
EXCESS LIAB
CLAIMS -MADE
DED RETENTIONS
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y I N
ANY PROPRIETORMARTNERIEXECUTIVE
STERTUTE OTH-
A ER
EACH ACCIDENT
$
E.L. DISEASE -EA EMPLOYE
OFFICERlMEMBER EXCLUDED? El
(Mandatory in NH)
NIA
N/A
E.L. DISEASE -POLICY LIMIT
__
$
If yes. describe under
DESCRIPTION OF OPERATIONS below
C
ProfessionalLiabili
TER2859945 I
7/31/2019
7/31/2020
SIR $150,000
10,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks
Certificate holder is named as additional Insured under the automobilie
Schedule, msy be sUmchad a more spew Is required)
liability andgeneralliability for work performed by the insured, only as required by
Written contract
CANCELLATION
CERTIFICATE HOLDER
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins
THE EXPIRATION DATE THEREOF, _ NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
P.O. Box 580
Fort Collins, CO 80522-0000
AUTHORIZED REPRESENTATIVE
..
ACORD 25 (201B%03) op 1933-2015 ACORD GOKYOKA I IUn. All ngma reserveo.
The ACORD name anlogo are registered marks of ACORD