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HomeMy WebLinkAbout694443 BLUEFIN LLC - INSURANCE CERTIFICATEBLUEFIN-02 CERTIFICA OF LIABILITY INSURANCE DATE(MMIDDA'YYY) sn7nn9n THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATEDOES 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 R&RtSENTATivif 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 certificate does not confer rahts to the certificate holder in lieu of such endoraementis). PRODUCER �rcens12rru191119 HUB International Insurance Services (COL) 111 S Tejon Street Colorado Springs, CO 80903 v�" e- N- En: : (9701541-6022 I iac. Nol: (866) 243-0727 I INSURED Bluefin,.LLC INSURER8:American Casual CO Of Read in PA Z04Z7 Bluefin Acquisit(on, LLC INSURER C : Continental Insurance Company of New Jersey 42625 6312 South Fiddlers Green Circle INSURER D : Suite 100E Greenwood Village, CO 80111 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: _ ---------- ------ THIS IS 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 HAVESEEN REDUCED BY PAID CLAIMS. - INSR TYPE OF INSURANCE ADDLINSO SUBR WVD POLICY NUMBER POLICY EFF POLICYEXPLTR 11MiT3. A X COMMERCIALGENERALLIABIUTY CLAIMS -MADE ❑X OCCUR X X 5093295832 - 9/1/1019 9/1/2020 EACH OCCURRENCE 11000,000 DAMAGE TO RENTED $ 100,000 MED EXP.(Any one erson $ 15,000 GEML PERSONAL S ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY Fx] Jppa LOC OTHER: GENERAL AGGREGATE. 2,090,000 PRODUCTS-COMP/OP AGO $. 2,000,000 B rmowLELIABILITY NYAUTOX WNEDSCHEDULED UpTEO�SONLYAUTNOSWNE UTOS ONLY AUTOS ONLD X 5093295829 9/1/2019 9/1/2020 COMBINEDSINGLELIMIT (Ea accident) $ 1QOQgg0 BODILY INJURY Per erson $ BODILY INJURY Per accident $ PeOraEcclRdent AMAGE $ A X UMBRELLA UAB X EXCESS LLAB OCCUR CLAIMS -MADE 1 6050570409 I 911/2019 9/1/2020 EACH OCCURRENCE $ 5,000,000 1AGGREGATE $ 5'B00'000 DED X RETENTION 10,000 _ C WORKERS COMPENSATION AND EMPLOYERS'LIABILITY AqNFYF�CPRO/PMREIETORIPARTNER/EXECUTIVE Y / N (Mend R M in )l EXCLUDED? (Nand ry i NH) Ir yes, dascdbe under DESCRIPTION OF OPERATIONS below N I A X 6080210025 4N/2020 4/1/2021 X $� ETH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE- EA EMPLOYE $ 1'000'000 E.L. DISEASE -POLICY LIMIT 1 Q00'000 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached N more s is aired) The city, its officers, agents and employees are additional Ins Iureds for General Liability and Ardonlob 'Fie' City of Fort Collins 300 Laporte Ave Building,B Fort Collins, CO 80521 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION_. DATE THEREOF, NOTICE WILL. BE. DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.. ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD :c CNA PARAMOUNT of Transfer of Rights of Recovery Against Others to the Insurer Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE_ _ Name Of Person Or Or anization: ANY PERSON OR ORGANIZATION WHOM THE CONTRACT OR AGREEMENT TO WAIVE SUCH CONTRACT OR AGREEMENT: NAMED INSURED HAS AGREED IN WRITING IN A RIGHTS OF RECOVERY, BUT ONLY IF SUCH 1. IS IN EFFECT OR BECOMES EFFECTIVE DURING THE TERM OF THIS COVERAGE PART; AND 2. WAS EXECUTED PRIOR TO THE BODILY INJURY, PROPERTY DAMAGE OR PERSONAL AND NJ ADVERTISING IURY GIVING RISE TO THE CLAIM. I (Information required to complete this Schedule, if not shown above, will be shown in the Declarations.) Under COMMERCIAL GENERAL LIABILITY' CONDITIONS, it is understood and agreed that the condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended by the addition of the following: With respect to the person or organization shown in the Schedule above, the Insurer waives any right of recovery the Insurer may have against such person or organization be of payments the Insurer makes for injury or damage arising out of the Named Insured's ongoing operations or your work included in the products -completed operations hazard. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policv. CNA75008XX (10-16) Page 1 of 1 The Continental Insurance Co Insured Name: BLUEFIN, LLC Copyright CNA All Rights Reserved. Policy No) 5093295832 Endorsement No: Effective Date: Includes copyrighted material of Insurance Services office, Inc., with its permission. CNA Business Auto Policy Policy Endorsement WAIVER OF TRANSFER OF RIGHTS AGAINST OTHERS To US (WAIVER OF RECOVERY OF SUBROGATION) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy indicated below. Named Insured: BLUEFIN, LLC Endorsement Effective Date: 09/01 /201 on the inception date of the policy Unless another date is SCHEDULE f Name(s) Of Person(s) Or Organization(s): ANY PERSON OR ORGANIZATION FORIWHOM OR WHICH YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER FROM US. YOU MUST AGREE TO THAT REQUIREMENT PRIOR TO LOSS. I Information required to complete this Schedule, if not shown above, will be shown in the Declarations.. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, bIut only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. Form No: CA 04 44 1013 1 Policy No: BUA 5093295829 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date: Endorsement No: 3; Page: 1 of 1 Policy Page: Underwriting Company: American Casualty Company of Reading, Pennsylvania, 151 N Franklin St, Chicago, IL 60606 1 0 Copyright Insurance Services Office, Inc., 2011