HomeMy WebLinkAboutGOVERNMENT BRANDS HOLDINGS LLC - INSURANCE CERTIFICATEClient#`. 93777
ACORD. CERTIFICATE
GOVEBRAN
LIABILITY INSURANCE
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), AUTHORU
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER
IMPORTANT: It the Certificate nolner is an ADDITIONAL INSURED, the poileypes) must nave ADDITIONAL 1145UREU 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 any rights to the certificate holder in lieu of such endomement(s).
PRODUCER g Patricia O'Neil
Edgewood Partners Ins. Center PNONE 6784755738
INC.
NC No Eli): AIC No).
2405 Satellite Blvd., Ste. 200 E-MAIL atricia.oneil icbrokers._com
ADDRESS: P @eP
Duluth, GA 30096
77O 232-0202 INSURER(S) AFFORDING COVERAGE NAIC d
INSURER A: Hartford Fire Insurance Company 19682
INSURED risuranea Corrioanb 127120
Government Brands Holdings, LLC
3025 Windward Plaza Suite 200
Alpharetta, GA 30005-8728
!N2,UMR o : Hartford Casualty Insurance Company �29424
iwariara n •Indian Harbor Insurance Co 36940
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS
BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
PR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
ADDL
INSR
SUB
I POLICY NUMBER
POLICY EFF
MMOD
POLICY EXP
MWDD
LINIn3
A
j(j
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE a OCCUR
X
X
2000kEF2748
D612012020
06/20/2021
EACH OCCURRENCE
$1 OOO 000
PREMISES Ea ocMcur�rence
$300000
MED EXP (Any one person
$10 000
PERSONAL & ADV INJURY
$1 000 000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY EC LOC
OTHER:
GENERAL AGGREGATE.
s2,000,000
PRODUCTS - COMPIOP AGG
$2,000,000
$
B
AUTOMOBILE
UABILn1'
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY X AUTOS ONLY
X
X
2000NEF2748
0 6/20/2020
06/20/2021
COMBINED SINGLE LIMIT
Ea accidem
1,000,000
X
BODILY INJURY (Per person)
$
X
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident1
$
Comp-1,000
$Coll-1,0.00
C
X1
UMBRELLALIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
X
X
20XHUEF3101
6/20/2020
06/20/2021
EACH OCCURRENCE
$5 000 000
AGGREGATE
$S 000 000
DED X RETENTION $10000
. _ . __
_$. --
A
A
WORKERS COMPENSATION
WORKERSCOM COMPENSATION
AND YIN
ANY PROP.RIETOR/PARTNERIEXECUnVE
OFFICERIMEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION. OF. OPERATIONS.below.
N I A
X
20WECAE6UOE
_
1/01/2020
01/01/2021
H-
H-
X PER UTE FORT
E.L. EACH ACCIDENT
$1 OOO OOO
E.L. DISEASE - EA EMPLOYEE
$1 000 000
E.L. DISEASE -POLICY LIMIT
$1000000.
D
D
E
Professional Liab
Cyber Liability
I Excess D&O &
X
X
MTP963664301
MTP903664301
IXMFl003589
6/20/2020
6/20/2020
6/20/2020
06/20/2021
06/20/2021
06/20/2021
5,000,000
5,000,000
5,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional
City of Fort Collins is included as additional insure
as as per written contract or agreement, subject to the
Remarks Schedule, may be attached If more space is n lulred)
with respect to General liability and Auto liability
policys terms, conditions and exclusions.
City of Fort Collins
PO Box 580
Fort Collins, CO 80522-0580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION .DATE THEREOF, _ NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVIs10NS.
*1 AtN AUA41
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) 1 _ of 1 The ACORD name and logo are registered marks of ACORD
#S2261311/111122612.71 1 RRICI