HomeMy WebLinkAbout553887 CRORY & ASSOCIATES INC - INSURANCE CERTIFICATE (3)CROR&AS-01 JLARSON
ACO�Q `� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD7YYYY)
6/30/2015
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:
Premier Agency, Inc. PHONE FAX
5 Sierra Gate Plaza 2nd FI A/c No at : (916) 784-1008 q/C No): (916) 784-8116
Roseville, CA 95678 ADDRESS:
INSURED
Crory & Associates, Inc.
Rick Crory
1198 Melody Ln Ste 110
Roseville, CA 95678
INSURER(S) AFFORDING COVERAGE J NAIC #
INSURER A: Hartford Casualty Insurance Company 129424
INSURER B: Hartford Accident and 22357
INSURER D :
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.
INSR
LTR
TYPE OF INSURANCE
ADDLSUBR
INSD
WVD
POLICY NUMBER
POLICY EFF
MM/DD
POLICY EXP
MM/DD/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 2,000,000
CLAIMS -MADE Al OCCUR
X
57SBARH6288
05/09/2015
05/09/2016
DAMAGE TO RENTeU-
PREMISES Ea occurrence
$ 1,000,00
X
MED EXP (Any one person)
$ 10,000
Tech E&O $3,000,000
PERSONAL & ADV INJURY
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 4,000,000
POLICY ❑ PRO ❑ LOC
JECT
PRODUCTS - COMP/OP AGG
$ 4,000,000
$
OTHER:
AUTOMOBILE LIABILITY
COBINED
EaMaccident SINGLE LIMIT
$ 1,000,000
BODILY INJURY (Per person)
$
B
X ANY AUTO
X
57UECZC7339
06/29/2015
05/09/2016
ALL OWNED SCHEDULED
AUTOS AUTOS
$
BODILY INJURY (Per accident)
PROPERTY DAMAGE
Per accident
$
NON -OWNED
HIRED AUTOS AUTOS
X
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$
B
EXCESS LIAB
CLAIMS -MADE
TBA
06/29/2015
05/09/2016
DED I I RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
PER OTH-
STATUTE I ER
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$
OFFICER/MEMBER EXCLUDED? ❑
N / A
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE
$
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
I $
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
The City of Fort Collins, its officers, agents and employees are included as additional insured with respects to general liability per attached SS0008 0405
endorsement and auto liability per attached HA9916 endorsement.
CFRTIFICATF HOI nFR CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins
ty
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Purchasing Dept
PO Box 580
AUTHORIZED REPRESENTATIVE
Fort Collins, CO 80522
C 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD