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603670 RTI INTERNATIONAL - INSURANCE CERTIFICATE
A CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS LY CERTIFICATE DOES NOT AFFIRMATIVEOR 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 REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT If the certificate holder is an ADDITIONAL IN URED, the poliey(ies) 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER - _ - ..CONTACT_. .. _._ NAME: - AOn Risk .Services South, Inc. - - charlotte NC office PHONE N,. E t). (866) 283-7122 (800) 363-0105 1111.Metropolitan Avenue, Suite 400 E-MAIL - - - charlotte Nc 28204 USA ADDRESS: - -- .-- International 0 Cornwallis Rd Box 12194 earth Triangle Park NC 27709-2194 USA INSURER(S) AFFORDING COVERAGE I NAIC # INsURERA: Continental Casualty Company 120443 INSURER C: AIU insurance company INSURER D: .American Home Assurance Co. INSURERS: New Hampshire insurance Company INSURER F: Lloyd's syndicate No: 2623 LR RFVIRICIN NIIAARFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW -HAVE -BEEN ISSUED TO THE -INSURED NAMED -ABOVEFORTHE -POLICY PERIOD - INDICATED. NOTWITHSTANDING_ ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 AI _ MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits: shown.are.as.requested LTR INSR TYPE OF INSURANCE INSD V761 POLICY NUMBER MMIDD MMIDD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS -MADE X❑OCCUR PREMISES Ea occurrence)$1,000,000 MED EXP (Any one Person), _ $_15_, 000 PERSONAL& ADV INJURY $1-1000,000 GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $2, Ogg,.000 LOC POLICY ❑JEa � PRODUCTS 00 $2,0,000 OTHER: B AUTOMOBILE LIABILITY 4034978456 06/01/2020 06/01/2021 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY ( Per person) ANYAUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED IXX PROPERTY DAMAGE ONLY - AUTOS ONLY Per accident - $1.000 Coll Dad X $1,000 Comp Dad UMBRELLA LMB EACH OCCURRENCE AGGREGATE EXCESS LIAR HOCCUR CLAIMS -MADE DED RETENTION C WORKERS COMPENSATION AND WC045886 10 06/01/2020 06/01 2021 X PER STATUTE I OTH- ER EMPLOYERS'LIABILITY YIN AOS E.L. EACHACCIDENT $1,000,000 C ANY PROPRIETOR/PARTNER/EXECUTIVE wc045886611 06/Ol/2020 06/Ol/2021 OFFICERIMEMBER EXCLUDED? In NFQ (Mes, N/A FL E1. DISEASE -EA EMPLOYEE $1,000,000 yandatory If dewdbo under DESCRIPTION OF OPERATIONS below E.L. DIS EASE -POLICY LIMIT $1,000,000 F E&O-MPL-Pr-imary w1B95B200501 06/01/2020 06/01/2021 Each Claim $1,000,000 iik Claims Made Aggregate Limit $1,000,000 SIR applies per policy ter I�Remarks s & cc ions DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Addllional Schedule, may be attached 8 more space U required) The City of Fort Collins its officers,agents and employees are included as Additional insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. CATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. The City Of Fort Collins, Co AUTHORRED REPRESENTATIVE Attn: Purchasing Department PO BOX Fort Collinsli CO 80522 USA d w C v '00 0 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016M) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000061132 LOC #: "4 ADDITIONAL- REMARKS SCHEDULE. Page _ of Aon Risk Services South, Inc. NAMED INSURED_ RTI International POLICY NUMBER See Certificate Number: 570081955935 CARRIER See Certificate Number: 570081955935 NAIC CODE EFFECTIVE DATE: 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 t:�J 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 Lim TYPE OF INSURANCE ADDL INSD SUBR WYD POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YYYY) POLICY EXPIRATION DATE (MM/DD/YYYY) LIMM WORKERS COMPENSATION D N/A WC045886612 CA 06/01/2020 06/01/2021 E N/A wc045886613 MA,ND,OH,WA,WI,WY 06/01/2020 06/01/202.1 ACORD 101 (2008/01) 02008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD