HomeMy WebLinkAbout449502 KUBRA DATA TRANSFER LTD - INSURANCE CERTIFICATE (3)A�Rf> CERTIFICATE OF LIABILITY INSURANCE
DATE /2015 YYYY)
0412312015
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 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
Marsh USA, Inc.
1166 Avenue of the Americas
CONTACT
NAME:
PHONE FAX
A/C No
E-MAIL
ADDRESS:
New York, NY 10036
Attn: newyork.cats@marsh.can
INSURER S AFFORDING COVERAGE
NAIC A
INSURER A: Travelers Property Casualty Co. of America
25674
034835-'MAIN-'ALL'-14-15 KUBRA
INSURED KUBRA DATA TRANSFER LTD.
INSURER B : Commerce & Industry Ins. Co
19410
2961 SIDCO DRIVE
INSURER C :
INSURER D :
NASHVILLE, TN 37204
INSURER E :
INSURER F :
rnvooer_ee PGOTIGIPATF fuURIIaFR• NYf.-M17n1579111 RFVISION NUMBER'3
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
OF INSURANCE
ADDLTYPE
iNgR
UBR
POLICY NUMBER
MM/DDIYYYY POLICY EFF
MOLD CY EXP
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE M OCCUR
TC2JGLSA- 1 78D3504-TIL-1 4
07101/2014
07/0112015
EACH OCCURRENCE
$ 1,000,000
AMAGE TO RENTED
PREMISES Ea occurrence)
$ 1,000,000
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 1,00I
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY PRO- LOC
PRODUCTS - CONI AGG
$ 2,001
$
A
AUTOMOBILE LIABILITY
IANY AUTO
ALL OWNED X SCHAUTEDULED
AUTOS X NON -OWNED
HIREDAUTOS AUTOS
X
X
TC2JCAP-178D353A-TIL-14
07/0112014
07/01/2015
COMBINED SINGLE LIMIT
Ea accident
1
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PPROPEERd�DAMAGE
$
B
X
UMBRELLA LULB
EXCESS LAB
X
OCCUR
CLAIMS -MADE
49131416
07/01/2014
07/01/2015
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$ 1,000,000
DIED I RETENTION$
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
YIN ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? ❑
(Mandatory in NH)
N yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
WC STATU- O FIR
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
$
E.L. DISEASE -POLICY LIMIT
1 $
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required)
CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED WHERE REQUIRED BY WRITTEN CONTRACT.
CITY OF FORT COLLINS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
ATTN: GERRY PAUL THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
DIRECTOR OF PURCHASING & RISK MANAGEMENT ACCORDANCE WITH THE POLICY PROVISIONS.
PO BOX 580
FORT COLLINS, CO 80522 AUTHORIZED REPRESENTATIVE
of Marsh USA Inc.
Daniel Rivera 9
v'IaDD-,dUTU AULIPCU L.LJrcrUKAI RJN. At rlgnis reserveu.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD