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Home My WebLink About144217 CCMSI HOLDINGS INC - INSURANCE CERTIFICATE (13)Client#: 67967 CCMSHOI ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE (MMlDDlYYYY)7123/2015 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). If Waiver of Subrogation is applicable, it only applies to the extent allowed by law. PRODUCER AME: NAME: Michelle Praxmarer N Mackey Team PHONE 312 595-8230 FAX 312 595-7163 A/C No Ext : A/C No Mesirow Insurance Services E-MAIL p ADDRESS: m raxmarer mesirowflnancial.com 353 N. Clark Street INSURER(S) AFFORDING COVERAGE NAIC# Chicago, IL 60654 INSURER A, Charter Oak Fire Insurance Comp 25615 INSURED INSURER B : Travelers Property Casualty Co. 25674 CCMSI Holdings, Inc INSURERC: Phoenix Insurance Company 25623 2 East Main Street, Suite 208 INSURERD: Federal Insurance Company 20281 Towne Centre Building n Underwriters at Lloyds London // INSURERE: Y l 15792 Danville, IL 61832 _ 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 ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I OCCUR X X P6301918P719COF14 11/17/2014 11/17/2015 $1000000 pEACHOCCURRENCE PREMISES Ea occur ence $1 OO,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY PEROCT X LOC J PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS X X P8101918P719COF14 11/17/2014 11/17/201 COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CUP1918P719TIL14 11/17/2014 11/17/201 EACH OCCURRENCE $10000 000 AGGREGATE $10 000 000 DED 1 X RETENTION $10000 Follow Form $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? N1 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPFRATIONS below N / A PNUB1918P71914 11/17/2014 11/17/201 X WC STATU- OTH- E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEEI $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 D E E&O -Primary $5M E&O -$5M XS $5M 82257026 HMPL15000039 7/31/2015 7/31/2015 07/31/201 $5M Occ/$5M Agg 07/31/20161 $5M Excess DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is named as additional insured under the automobile liability and general liability for work performed by the insured, only as required by written contract. t.cn i iris m i c nULUCK City of Fort Collins P.O. Box 580 Fort Collins, CO 80522-0000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE a ACORD 25 (2010/05) 1 of 1 #Sl8646631M1864506 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD LZC