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HomeMy WebLinkAboutMARCH OF DIMES FOUNDATION - INSURANCE CERTIFICATEACC ® CERTIFICATE OF LIABILITY INSURANCE DATEOM 2/D201) 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 Northeast, Inc. New York NY Office CONTACT NAME: (800) 363-0105 (A/C. No. Ext): (866) 283-7122 jvC No.): E-MAIL ADDRESS: 199 Water Street New York NY 10038-3551 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Great Northern Insurance Co. 20303 March Of Dimes Foundation INSURERB: Vigilant Ins CO 20397 1275 Mamaroneck Ave Whit white Plains n5 NY 10605 USA INSURERC: The Travelers Indemnity Co. 25658 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570059891156 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 A X COMMERCIAL GENERAL LIABILITY S 7771 1 1 1 EACH OCCURRENCE $1, OOO, OOO CLAIMS -MADE X❑ OCCUR DAMAGE RENTED PREMISES Ea occurrence $1,000,000 MED EXP (Any one person) $10, 000 PERSONAL & ADV INJURY $1, 000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2 , 000 , 000 POLICY X PRO- JECT F] LOC PRODUCTS - COMP/OP AGG $2,000,000 OTHER. A AUTOMOBILE LIABILITY 73525021 10/31/2015 10/31/2016 COMBINED SINGLE LIMIT Ea accident $1, 000, 000 BODILY INJURY ( Per person) X ANY AUTO BODILY INJURY (Per accident) ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS 1.1 J PROPERTY DAMAGE Per accident X Coll Ded $1,000 Comp Ded $1,000 11 C X UMBRELLA LIAB X OCCUR ZUP71M1676715NF 10/31/2015 10/31/2016 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $ 5 , 000 , 000 DED I X RETENTION $10, 000 Products/Completed O $ 5 , 000 , 000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR / PARTNER / EXECUTIVE YIN (16)71737006 10/31/2015 10/31/2016 X STATUTE ERH E.L. EACH ACCIDENT $1 , OOO , OOO OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) ❑ N / A E.L. DISEASE -EA EMPLOYEE $1 , 000 , 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE-POL ICY LIMIT $1 , 000 , 000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Event Name: March for Babies-Larimer County, Event Location: City Park -Ft. Collins, Event Date: 04-25-2015. 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 Attn: Risk Management Po Box 580 Fort Collins CO 80522-0580 USA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD