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HomeMy WebLinkAbout640805 APPLIED SOFTWARE TECHNOLOGY INC - INSURANCE CERTIFICATE (2)APPLSOF-01 STHOMAS DAT/11D/YYYYI 3M9129/2020_ - ,a►COR®' CERTIFICATE OF 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), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE.HOLDER.. 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 the policy, certain policies may require an endorsement. A statement on this certificate does not confer rightsto the certificate holder in lieu of such endorsements . PRODUCER C N ACT Spellings Walters Insurance Agency 1117 Perimeter Center West PHONE FAX ac, No; Ert : (770) 396-5600 ac; No :(770) 399 9880 Suite W101 Atlanta, GA 30338 INSURER 5 AFFORDING COVERAGE NAIC p INSURER A: Travelers Property & Casualty 26674 INSURED INSURERS: Travelers Indemnity Co/America 25666 INSURER C : Applied Software Technology, Inc. INSURER D : 5901 Peachtree Dunwoody Road, Ste C230 Atlanta, GA 30328 INSURERE: INSURER F: r nVPRAOPS. r-mmizICATP NI IMRPR• RPVISIrW NIIMRPR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDI-CATED. 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. ILSR TYPE OEINSURANCE ADDL SUBR POLICY NUMBER. POLICY EFF POLICY EXP _ _ LIMITS _ A X COMMERCIAL GENERALLIABILITY CLAIMS -MADE X OCCUR X ZLP.61M28627 3/20/2020 W20/2021 EACH OCCURRENCE 1,000,000 $ DAMAGE TO RENTED PREMISES (Ea octurrencelMED $ 500,000 EXP (Any oneperson) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY JRO- LOC OTHER. EBL ECT GENERAL AGGREGATE $ 2,000,000 PRODUCTS AGG $ 2,000,000 %( $ 1,000,000 A AUTOMOBILE UABIUTY ANY AUTO OWNED SCHEDULED AUTOS ONLY ALTNOSW-NED AUTOS ONLY X AUTO ONLY X BA$L468799-19-15-G 3/20/2020 3/20/2021 COMBINEeIN D SGLE LIMIT (Ea acc;clX $ 1,000,000 .BODILY INJURY Per person)$ .BODILY INJURY Per accident $ X (Per PROPERTY DAMAGE $ - A X UMBRELLA L AB EXCESS UAB X_ OCCUR CLAIMS -MADE CUP-8M769033 3/20/2020 3/20/2021 EACH OCCURRENCE $ 3,000,000 AGGREGATE. $ 3,000,000 DED X RETENTION$ 10,000 Prods/Comp Ago $ 3,000,000 B WORKERS COMPENSATION AND EMPLOYERS'LIABIUTY ANY CPR�OPREIETORIPARTNERIEXECUTIVE Y� (ssandE.R/,M n EXCLUDED? IM If yes, describe under DESCRIPTION OF OPERATIONS below NIA UB-008d73t52A 1/1/2010 - 1/1/2021 X PER OTH- TAT T R E.L. EACH ACCIDENT. 11000,000 $ E.L. DISEASE - EA EMPLOYE 8 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 $ A A Property Cyber Liability LP-61M28627 PL-16N1529A 3/20/2020 3/20/2020 W20/2021 31/20/2021 Blkt Limit --RC Each Wrongful Act 1,785,000 5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached a more space Is required) RE: City of Fort Collins Hired Car Physical Damage: $100 comp &.$SOO collision deductible. Owned Auto Physical Damage: $500 comp & $500 collision deductible. City of Fort. Collins PO BOX 580 Fort Collins, CO 80522 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 ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: APPLSOF-01 LOC #: 1 STHOMAS AC®R®' llhc� ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED nelln s Walters Insurance Agency Apppplied Software Technology Inc. g g y 590.1.Peachtree Dunwoody Road, Ste C230 POLICY NUMBER Atlanta, GA. 30328 SEE PAGE 1 CARRIER NAIC CODE SEE. PAGE 1 SEE P 1 EFFECnVEDATE: SEE PAGE I ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Forms Remain Same Per Expiring General Liability CGD4250708 - Other Insurance Additional Insured Primary & Non -Contributory CGD4170112 - Technology Xtend Endorsement Auto: CAT3530215 - Business Auto Extension Additional Named Insureds: Applied Professional Services, Inc. The D.C. Cadd Company, Inc. Applied Construction Technology, Inc. CAD-1 Inc. eVolve MEP, LLC Applied Software Holdings, Inc Page 1 of 1 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD