HomeMy WebLinkAbout342049 MICHOW COX & MCASKIN LLP - INSURANCE CERTIFICATE1CH1� CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD(YYYV)
04/06/2020
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 pollcy(les) must be endorsed. If SUBROGATIONIS 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 Ileu of such endorsement(s).
PRODUCER
CONTACT
CHERRY CREEK INS AGENCY INC/PHS
34342353
The Hartford Business Service Center
NAME--
PHONE (866)467-8730
(A/C, No, Ert):
FAX (888)443-6112
(A C, NO):
3600 Wiseman Blvd
E-MAIL
San Antonio, TX 78251
ADDRESS:
INSURER(8) AFFORDING COVERAGE NAICe
INSURED
INSURER A: Sentinel Insurance Company Ltd.
11000
MICHOW COX & MCASKIN LLP
6530 S YOSEMITE ST STE 200
Hartford Insurance Company of the
INSURER B : Midwest
37478
GREENWOOD VILLAGE CO 80111-5128
INauaERC:
INSURER D
INSURER E
INSURER F:
COVERAGES CERTIFICATE NUMBER- RFVISITNd NIINIRFR-
THIS 15 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.
INSR
TYPE OF INSURANCE
ADDL
BURR
POLICY NUMBER
POLICY EFF
POLICY EXP
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$2,000,000
. CLAIMS-MADEaOCCUR
DAMAGE TO RENTED
$1,000,000
General Liability
X
MED EXP (Any one person)
$10,000
A
X
34 SBA 114860
03/01/2020
03/01/2021
PERSONAL & ADV INJURY
$2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$4,000,000
POLICY ❑ RPRO-
O - LOC
PRODUCTS - COMP/OP AGO
$4,600,000
OTHER:
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
fra accident)
$2,000,000
ANY AUTO
BODILY INJURY (Per person)
A
ALL OWNED F7 SCHEDULED
AUTOS AUTOS
X
34 SBA 114860
03/01/2020
03/01/2021
BODILY INJURY (Per accident)
X
HIRED NON -OWNED
AUT09 X AUTOS
PROPERTY DAMAGE
(Per accident)
UMBRELLA LULB
OCCU
EACH OCCURRENCE
EXCESS LIAR
CLAIMS.
MADE
AGGREGATE
ED RETENTION $
WORKERS
AND EMPLOYERS' LIABILITY
X
PER
OTH-
B
ANY YIN
PROPRIETORIPARTNER/EXECUTIVE
OFFICERMIEMBER EXCLUDED?
W A
34 WEC C05095
03/01/2020
03I01/2021
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE -EA EMPLOYEE
$500,000
(Mandatory In NH)
If yes, describe under
E.L. DISEASE - POLICY LIMIT
$500,000
N OF OPERATIONS
777
DESCRMWONOF OPERATIONS/LOCATIONSIVEHICLE8 (ACORD 101, Additional Remarks Schedule, may be attached R more space Is required)
Those usual to the Insureds Operations. Certificate holder is an additional Insured per the Business Liability Coverage Form SS0008 and the Hired
Auto and Non Owned Auto Endorsement SSO438, attached to this policy.
GERTIFICATE MOLOER CA1MCFLLATIn1M
City of Fort Collin
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
Attn: Purchasing Dept.
BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED
PO BOX 580
IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
FORT COLLINS CO 80522-0580
CSC a3' Cao�
01988.2015 ACORD CORPORATION. All rights reserved.
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