HomeMy WebLinkAbout104254 GALLS LLC - INSURANCE CERTIFICATE (2)Client#: 1778682
CBGENERHO1
ACORD. CERTIFICATE OF LIABILITY INSURANCE
UATE(MMIDDfm
3/1112020
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 any rights to the certificate holder In lieu of such endorsement(s).
PRODUCER
CONTACT - - --
NAME:
USI Insurance Services LLC
.PHONE
ac No Est : 513 052-6300 A/C No): 513 852-6428
312 Elm Street, 24th Floor
E-MAIL
Cincinnati, 45202
ADDRESS:
513 852300
INSURER(S) AFFORDING COVERAGE
NAIL#
.INSURER A': OBE Itaurana terporaaon
39217
INSURED
Gaits, LLC
INSURER B': Gana -Casualty Company of Wisconsin
2"14
INSURER C : praatorlan lrnurence Company
37257
1340 Russell Cave Road
INSURER D: The Clndm a.insuranc,Company
10677
Lexington, KY 4050$
INSURER E : Gnat American E a s Insurance Company
37532
INSURER F:
COVERAGES CERTIFICATE NUMRFR- DFvlslnal ainaanco•
THIS 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 HAVE BEEN REDUCED BY PAID CLAIMS.
R
IN LTR
TYPE O F INSURANCE
ADDL
INSR
IV
VIV
POLICY NUMBER
POLICCY EFF
MM/DD(MMIDRNYM
POLICY EXP
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE L ^ OCCUR
X
X
CGA1365959
3/01/2020
03/01/2021
EACHOCCURRENCE
$1 OOO 000
PREMISES EaEoNcCT59nce
$1 OOO OOO
MED EXP (Any one person)
000
PERSONAL B ADV INJURY
00,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRO -
POLICY JECT X ILOC
GENERAL AGGREGATE
00,000
PRODUCTS - COMPIOP AGG
E$22,000,000
OTHER:
A
AUTOMOBILE
LIABILITY
X
X
CBA1366969
3/01/2020
03/01/2021
COMBINED SINGLE LIMITEa accident
00,000X
BODILY INJURY(Per person)
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY X AUTOS ONLY
BODILY INJURY (Per accident)
$
X
PROPERTY DAMAGE
Per accident
$
$
B
�(
UMBRELLA LIAR
X
OCCUR
CCU1365959
3/01/2020
03/01/2021
EACH OCCURRENCE
$10 00O 000
AGGREGATE.
$16OOO OOO
EXCESS LIIB
CLAIMS -MADE
DED I X RETENTION $1 O 000
$
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
MY PROPRIETOR/PARTNERIEXECUTIVE YIN
OFFICER/MEMBER EXCLUDED? �
N I A
CWC1365959
3/61/2020
- -
03/01/2021
X PER OTH-
STATUTE
E.L. EACH ACCIDENT
$1 OOO OOO
E.L. DISEASE - EA EMPLOYEE
$1 000 000
(Mandatory In NH)
It yS6 describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE • POLICY LIMIT
$1,066,066
D
Excess Liability
EXS0570374
3/01/2020
03/01/2021
$15,000,000 Limit
E
E I
Pollution
PREE29196800 ID,1131/1018101131/20211
$3,000,000 Limit
--
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be att_acbetl if -more space Is required)
Contract #8085 Police Uniforms.
The General Liability and Automobile Liability policies include an automatic:Additional Insured endorsement
that provides Additional Insured status to City of Fort Collins, only When there is a written contract that
requires such status, and only with regard to work performed on behalf of the named insured.
City of Fort Collins
215 N. Masson St. 2nd Floor
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
All riahts reserved
ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S28183318/M28117946 HKYZP