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HomeMy WebLinkAboutCOMVERGE INC - INSURANCE CERTIFICATE (2)207326 ACI R& CERTIFICATE OF LIABILITY INSURANCE DATE 5/12/2015m 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($). PRODUCER CONTACT Kris Thompson Commercial Lines - (813) 639-3000 PHONIE 813-639-3058 F� No): 813-639-7196 Wells Fargo Insurance Services USA, Inc. E-MAIL o.comth kris.om son wellsfar ADDRESS: P @ 9 2502 N. Rocky Point Drive, Suite 400 INSURERS AFFORDING COVERAGE NAIC # Tampa, FL 33607 INSURER A: Liberty Mutual Fire Insurance Cc 23035 INSURED INSURER B : Liberty Insurance Corporation 42404 Comverge, Inc. INSURERC: First Liberty Insurance Corporation 33588 5390 Triangle Parkway Indian Harbor Insurance Company36940 INSURER D : INSURER E : Norcross, GA 30092 INSURER F : COVERAGES CERTIFICATE NUMBER: 9099469 REVISION NUMBER: See below 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. ILTRR OF INSURANCE ADDLITYPE INSO WVO SUER POLICY NUMBER MWDDYIYYYY) (MM/DDfYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR TB2Z91462186025 2/28/2015 2/28/2016 EACH OCCURRENCE $ 1,000,000 DAMA E T RENTED PREMISES Ea occurrence $ 1,000,000 X MED EXP (Any one person) $ 10,000 PD DED 10,000 X Primary & Non -Contributory PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JET LOC PRODUCTS-COMP/OP AGG $ 2,000.000 $ OTHER: A AUTOMOBILE LIABILITY TB2Z91462186025 2/28/2015 2/28/2016 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Pereaklant) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ E B X UMBRELLA LIAB X OCCUR TH7Z91462186065 2/28/2015 2/28/2016 EACH OCCURRENCE $ 20,000.000 AGGREGATE $ 20,000,000 EXCESS LIAR CLAIMS -MADE DED I X I RETENTION $ 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NI (Mandatory In NH) NIA WC6Z91462186045 2/28/2015 2/28/2016 X STATUTE ERH IT - E.L. EACH ACCIDENT 1,000,000 E E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yea describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 D Errors &Omissions MTP004059202 05/15/ZOtS 10/31/2016 $2,000,000 Each Occurrence $2,000,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached U mom space Is required) The City of Fort Collins, its officers, agents and employees shall be named as additional insureds as it relates to general and auto liability in accordance with the terms and conditions of the policies. 30 day notice of cancellation except for non payment of 10 days. City of Fort Collins City Clerk PO Box 580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE I The ACORD name and loco are reaistered marks of ACORD ©1988-2014 ACORD CO riahts reserved „"°» °°."„ IIOIV1INOIgIIII11IIII111111111111IYNll111ll111ln ._.,_. __