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HomeMy WebLinkAbout106536 MILLIMAN INC - INSURANCE CERTIFICATE (5)A �® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 06/24/2015 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 CONTACT NAME: Parker, Smith & Feek, Inc. 2233 112th Avenue NE Bellevue, WA 98004 AHiCNN E .425-709-3600 No:425-709-7460 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIL S INSURERA: National Fire Ins. Hartford INSURED Milliman, Inc. INSURER B : Valley Forge Insurance Company 1301 Fifth Ave., Suite 3800 INSURER C : INSURER D : Seattle, WA 98101 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSIR LTR TYPE OF INSURANCE NSg SUER POLICY NUMBER EFF MM/DD/YYW MM DD/YPOLICY XP POLICY EYYY LIMITS A GENERAL x LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE " OCCUR 6012743223 6/30/2015 6/30/2016 EACH OCCURRENCE $ 1,000,000 DAMA E TO RENTED PREMISES Ea occurrence $ 1,000,000 x MED EXP (Any oneperson) $ 15,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO- I X LOC JECT PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE x LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS 6012743237 6/30/2015 6/30/2016 EaaacccdentSINGLELIMIT $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ UMBRELLA LIAR EXCESS LIAR HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ DIED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y f N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N /A 6012743240 6/30/2015 6/30/2016 WC STATU- x OTH- TORY LIMIT E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 $ i DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Exhibit of Insurance. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF FORT COLLINS ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Jim Hume AUTHORIZED REPRESENTATIVE 256 West Mountain Avenue Fort Collins, CO 80522-0580 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD o MILLIMAN (ALGOO)