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HomeMy WebLinkAbout457775 FARNSWORTH INC - INSURANCE CERTIFICATE (2)A� Q® CERTIFICATE OF LIABILITY INSURANCE DAT3/31/2DNYVV) 3/31 /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 policy(les) 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_Ileu of such endorsement(s). PRODUCER - - - - - Cottingham 8 Butler Robert Heath 800 Main St. CONTACT NAME: PHONE 563-587-5000 a No:S63-58377339 MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIL# Dubuque IA 52001 .INSURERA: Hartford Fire Insurance Company 19682 INSURED FARNGRO-0.1. Famsworth Group, Inc. 2709 McGraw Drive INSURER B:Travelers Property Casualty Company of America 25674 INSURERC: Twin City Fire Insurance Co. 29459 Bloomington IL 61704 INSURER D : :INSURER E :. INSURER F r Cr1VFRAGFS CFRTIFICATF NIIMRFR- 119RQG5R53 REVISION NUMBER: 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. INSR LTR TYPE OF INSURANCE- ADOL SUER POUCY.NUMBER POLICY EFF MM DDNYYYI POLICY EXP (MM/DDNrm -- LIMITS A X COMMERCIALGENERALLIABfLITV CLAIMS -MADE F-VI OCCUR 83 LIEN OB 8121 4/l/2020 4/1/2021 EACH OCCURRENCE $1,000,000 DAMAGE Ea PREMISES ddiurience $ 300,000 MED EXP (Any one person) $10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY a PRJECT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ 2,000,000 $ A AUTOM081LELIABILm' X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 83UENOB8122 4/1/2020 4/1/2021 COMBINED SINGLE LIMIT Ea accid ent $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ B X UMBRELLALIAB EXCESS LIAa X OCCUR CLAIMS -MADE ZUP-6,1M71617 41112120 4/1/2021 EACH OCCURRENCE $6,000,000 AGGREGATE $ 6,000,000 DED I I RETENTION$. $__ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMB ER EXCLUDED? (Mandatory In NH) If as, describe under OE SCRIP.TIONOF_OP.ERATIONSbelo NIA 83 WE OB8GOH 4/1/2020 4/1/2021 .. X I ERSTATUTE ERH E.L. EACH ACCIDENT E 1,000,000 E.L. DISEASE - EA EMPLOYEE $1.000,000 E.L. DISEASE -POLICY LIMIT $.1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space Is required) The certificate holder is additional insured on the General Liability and Auto Liability policies per written contract between the named insured and the certificate holder that requires such a status subject to the terms and conditions of the endorsement attached to the policy. CERTIFICATE HOLDER UAr4k lCLL kI IUrn SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE- WILL BE DELIVERED IN ACCORDANCEWITH THE -POLICY PROVISIONS. City of Fort Collins 215 N. Mason St. 2nd Floor AUTHORIZED REPRESENTATIVE Fort Collins CO 80522 -0— - - - ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD