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Home My WebLink About114432 VERIZON WIRELESS LLC - INSURANCE CERTIFICATEA DATE(MM12020 V1') CERTIFICATE F LIABILITY INSURANCE D6/DB,2D2D 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 REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, SUBROGATION IS WAIVED,.subject to the terms and conditions the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If of the policy, certain policies may require an endorsement. A statement on this .2 certificate does not confer rights to the certificate holder -__-_ _ in lieu of such endorsement(s). PRODUCER__. - - - Aon Risk Services Northeast, Inc. New York NY Office One Liberty Plaza 165 Broadway, suite 3201 New York NY 10006 USA _-. CONTACT NAME: ID 13 9 'C _ - FAX (A/C;N1. Ext): (866) 283-7122 (A�. No : (800) 363-0105 EMAIL ADDRESS: -- - INSURER(S) AFFORDING COVERAGE NAIC p INSURED INSURER A: National Union Fire Ins co of Pittsburgh 19445 verizon Wireless, LLC 1095 Avenue of the Americas INSURERB: AIU Insurance company 19399 Ir_isuRERc: American Horne Assurance co. 19380 New York NY 10036 USA INSURERD: New Hampshire insurance company 23841 INSURER E: THIS ISTOCERTIFY 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 RESPECTTO 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 d LTR TYPE ONSURANCE F I INSD WVD POLICY NUMBER D LIMITS X COMMERCIAL AL UABUTY GL EACH OCCURRENCE $4,000,000 CLAIMS -MADE ❑X OCCUR - PREMISES Ea occurrence $4,000,000 X MED EXP (Any one person) $10, 000 XCU Coverage is Included PERSONAL B ADV INJURY $4,000,000 GEN'LAGGREGATE LIMIT APPLIESPER: K POLICY PRO. FILOC GENERALAGGREGATE $4,000,000 PRODUCTS - COMP /OPAGG $4,000,000 OTHER: - - -- A AUTOMOBILE LIABILITY' CA 4594298 A05 06/30/2020 06/30/2021 COMBINED SINGLE LIMIT n $2,000,000 - BODILY INJURY (Per person) A A X ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED ONLY AUTOS ONLY CA 4594299 MA CA 45 VA 4300 06/30/2020 06/30/2020 06/30/2021 06/30/2021 BODILY INJURY (Per accident) PROPERTY DAMAGE Per accident - - - A see Next Page 06/30/2020 06/30/2021 UMBRELLALWB OCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS -MADE AGGREGATE DIED RETENTION B O WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICEREMBEREXCLUDED' (Mandatory In HIM Ups, describe under DCRIPTION OF OPERATIONS below N/A WC045886576 ADS WC045886575 CA 06/30/2020 06/30/2020 06/30/2021 06/30/2021 X PER STATUTE I OTH- R E.L./MEACH ACCIDENT -- - - $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 E.L. DISEASE PO LIMB $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEMCLFS (ACORD 101, Addittonal Remarks Schedule, may be attached B more apace Ls required) city of Fort Collins its officers, officials and employee are included as Additional Insured with respect to the General Liability and Automobile Liability policies. The General Liability policy shall apply as Primary Insurance to each Additional insured listed herein. where permitted by law, the Named Insured parties listed herein waive all rights against city of Fort Collins, its officers, officials and employee listed herein for recovery of damages to the extent these damages are covered by the General Liability, Automobile Liability and workers' compensation policies referenced herein and, as further limited by written contract between the parties. The above -referenced General Liability policy shall 'cover the tort liability of the certificate holder assumed under the underlying agreement between parties for which the certificate has been issued. CERTIFICATE HOLDER CANCELLATION City of Fort Collins PO Box 580 Fort Collins CO 80522-0580 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE _-_. POLICY PROVISIONS. -- AUTHORIZED REPRESENTATIVE @1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD ,name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000027366 LOC #: A ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY NAMEDINSURED Aon Risk Services Northeast, Inc. verizon wireless, LLC see Certificate Number: 570082120215 CARRIER NAIL CODE see certificate Number: 570082120215 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LTR _ TYPE OF INSURANCE ADDL INSD SUBR �VVD -- POLICY NUM13ER - _ POLICY EFFECTIVE DATE MM/DD/YYYY) POLICY EXPIRATION DATE (MM/DD/YYYY) - - LIMITS AUTOMOBILE LIABILITY A CA 4594301 NH - Primary 06/30/2020 06/30/2021 A CA 4594302 NH - EXcesS 06/30/2020 06/30/2021 WORKERS COMPENSATION B N/A wc045886579 NY 06/30/2020 06/30/2021 B N/A wc045886577 FL 06/30/2020 06/30/2021 b - '' N/A WC045886578 MA,ND,OH,WI,WY 06/30/2020 06/30/2021- B N/A WC045886574 NJ;TX,VA 06/30/2020 06/30/2021 ACORD 101 (20(18I01) ® 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD