Loading...
HomeMy WebLinkAbout120248 GILLIG CORP - INSURANCE CERTIFICATEACC ® CERTIFICATE - F L-IABIL-IW INSURANCE DATE(MWDD/YYYY) 09/30. 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 'T ' AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES -CONSTITUTE- L6W. 1S FPROE' dF NO,T NAND A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REVE OR THE CERTIFICATE O 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 thepohcy, certain policies may require.an endorsement. A statement on this c certificate r does not confer to the certifih cate older ip lieu of such endorsement(a). PRODUCER -- - CONTACT p pEE AOn Risk Services Northeast, Inca (866) 283-7122 FAX (800) 363-0105 Cincinnati OH Office (A/C.No. Ext): A/C No.): EMAIL 8044 Montgomery Road p Suite 405 ADDRESS: _ _ _... Cincinnati OH 45236-2919 USA - - - - - - INSURER(S) AFFORDING COVERAGE NAIC 9 INSURED INSURER A: Everest National Insurance CO 10120 GILLIG LLC INSURER B: Everest Premier Insurance Company 16045 451 Discovery Drive Livermore. CA 94551 USA INSURERC: Lloyd's Syndicate No. 2003 AA1128003 1 1 1 INSURER F: I I Cr1VFRAnFR CFRTIFICATF NIIMRFP- 57nn7A5Q.U74 RFVI-SiON NIIMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE-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. Limits shown are as. requested INSR LTR TYPE OF INSURANCE INSD WVD ROLICY NUMBER MM/DD MWDDNYYY LIMBS _A. X_ LY COMMERCIALGENERALLUABIIT R C GL EACH OCCURRENCE _ _.. $S,000,OOO .._ _ CLAIMS -MADE X❑ OCCUR SIR applies per policy terns & condi ions- PREMISES Ea occuRenre $300,000 MED.EXP (Any one person) Excluded PERSONAL & ADV INJURY $5,000,000 GEN'LAGGREGATELIMITAPPLIESPER: GENERALAGGREGATE S5,000,000 X POLICY ❑PEa FjLOC PRODUCTS-COMP/OPAGG $5,600,000 OTHER: A AUTOMOBILELIABILITY RM8CA000 4-191 10/Ol/201910/Ol/2020 COMBINED SINGLE LIMIT (Ea accident) $2,000,000 BODILY INJURY ( Per person) X ANYAUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED _ ONLY AUTOS ONLY X GKLL PROPERTY DAMAGE- Per auldent - .Garage Keepers Liability $1,000,000 C X UMBRELLALUAB X OCCUR CSUSA190 612 10/01/201910/01/2020 EACHOCCURRENCE $101-0001000 EXCESS LIAB CLAIMS -IMAGE AGGREGATE $10,000.,000 DED X RETENTION f10, 000 B e - WORKERS COMPENSATION AND EMPLOYERS LIABILnYIN ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? (MandatoryinNM If yes, describe. under 'uECCRIPTiO:v OF'OPEF;ATIGJG belax N/A RM8wc000 AY - RM8wc00027191 Retro 4191 1 /O1/2019 10/01/2019 10 01/20,20 10/01/2020 PER OTH- X STATUTE E.L. EACH ACCIDENT $1,000,000 - E.L. DISEASE -EA EMPLOYEE $1,000,000 - - �-:L DIbEnS VLICY LIMB_ $1,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLESIACORD 101, AddlOodal.Ri—=r)aScheduli, RE: 8563 Transfort Bus Procurement- Multiple Lengths. may be ittached N more space Is requimd) City of Fort Collins is included as Additional insured in 'accordance with thepolicyprovisions of the General Liability policy. CERTIFICATE HOLDER CANCELLATION L" SHOULD ANY OF THE ABOVE DESCRIBED CIEE CANCELLED ED POLICIES BE BEFORE THE _ _ .. - EXP IRATION DATE THEREOF, -NOTICE WILL BE DE LIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins AUTHORIZED REPRESENTATIVE Attn: Kathy RECtor, Purchasing -- -- - - 215 N. Mason street, 2nd Floor Fort Collins c0 80522 USA ACORD 25 (2016/03) ©1988-2.615 ACORD CORPORATION., Ali rights reserved. The ACORD IN me and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000073126 LOC #: '°' ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk services Northeast, Inc. NAMEDINSURED GILLIG LLC POLICY NUMBER see certificate Number: 570078593474 CARRIER see certificate Number.: 570078593474 NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER ADDITIONAL_ POLICIE_ S If a policy below does not include limit infonnation, refer to the corresponding policy on the ACORD certificate form for policy limits. LTR TYPE OF INSURANCE Il�VSI/ Sw D POLICY NUMBER POLICY EFFECTIVE DATE M/DD POLICY EXPniATION DATE MM/DD LUAUS WORKERS COMPENSATION - g N/A RM8wco0026191 FL, ME, N] 10/01/2019 10/01/2020 ... ACORD 101 (2008/01) ®2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD