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U S SECURITY ASSOCIATES INC - INSURANCE CERTIFICATE (2)
CERTIFICATE OF LIABILITY INSURANCE DAT 07/221220115 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 AOn Risk Services South, Inc. Atlanta GA Office CONTACT NAME: (A/CC..NNo. Ext): (866) 283-7122 FAX No.): (800) 363-0105 E-MAIL ADDRESS: 3565 Piedmont Rd NE,Blgl,#700 Atlanta GA 30305 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Liberty Mutual Fire Ins CO 23035 U. S. Security Associates, Inc. INSURER B: Lexington Insurance Company 19437 200 Mansell Court East Sth Floor INSURERC: National Union Fire Ins CO Of Pittsburgh 19445 INSURER D: Liberty Insurance Corporation 42404 Roswell GA 30076 USA INSURER E: INSURER F. COVERAGES CERTIFICATE NUMBER: 570058756070 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. Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS B X COMMERCIAL GENERAL LIABILITY0470827491 EACH OCCURRENCE $2 , 000 , 000 SIR applies per policy terns & COndl ions DAMAGE$500,000 CLAIMS -MADE ❑X OCCUR PREMISES Ea occurrence MED EXP (Any one person) $10 , 000 PERSONAL &ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4 , 000 , 000 POLICY ❑ PRO 7 LOC JECT PRODUCTS - COMP/OPAGG Included OTHER. Professional Liability Included A AUTOMOBILE LIABILITY AS2-641-443931-055 08/01/2015 08/01/2016 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY ( Per person) ANY AUTO BODILY INJURY (Per accident) X ALL OWNED SCHEDULED AUTOS AUTOS JXX PROPERTY DAMAGE HIRED AUTOS X NON -OWNED (Per accident) AUTOS C 19086555 08/01/2015 08/01/2016 $5,000,000 X UMBRELLALIA13 X OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS -MADE AGGREGATE $ 5 , 000 , 000 DED I X RETENTION $25,000 D WORKERS COMPENSATION AND wA764D443931015 08/01/2015 08/01/2016 X STATUTE ORH EMPLOYERS' LIABILITY YIN AOS E.L. EACH ACCIDENT $1 , 000 , 000 D ANY PROPRIETOR / PARTNER / EXECUTIVE N NIA WC7641443931045 08/01/2015 08/01/2016 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) wI E.L. DISEASE -EA EMPLOYEE $1, 000, 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L DISEASE -POLICY LIMIT $1 . 000 , 000 B Excess Auto Lia 048409879 08/01/2015 08/01/2016 Each Occurrence $4,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is included as Additional Insured in accordance with the policy provisions of the General Liability policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of Fort Collins AUTHORIZED REPRESENTATIVE Purchasing Department P.O. BOX 280 Ft. Collins Co 80522 USA rn m c m 73 N 12 0 2 0 t` 0 oo 0 0 O Z 61 JU t 41 U ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD