HomeMy WebLinkAboutRSM US LLP - INSURANCE CERTIFICATEACQRD CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
11 /24/2015
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
Marsh USA Inc.
2405 Grand Boulevard, #900
Kansas City, MO 64108
Attn: KansasCity.CertRequest@marsh.com Fax: 212-948-0015
CONTACT
NAME:
PHONE xt _ (A/C No):
_
ADDRESS: -----
- -
--
INSURER(S) AFFORDING COVERAGE
NAIC p
INSURER A : Sentry Insurance A Mutual Company
24988
102813 _ REastm
INSURED
RSM US LLP
INSURER B : Sentry Casualty Company
28460
INSURER c : Federal Insurance Company
20281
One South Wacker Drive, Suite 800
Chicago, IL 60606
INSURER D :
INSURER E
INSURER F :
COVERAGES CERTIFICATE NUMBER: CHI-006058137-08 RFVICIr1N1 IW IMRFD•10
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 SUBR POLICY EFF POLICY EXP
POLICY NUMBER MMIDD/YYYY) (MM/DDIYYYYI LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE N OCCUR
90-18524-04
11/30/2015
11/3012016
EACH OCCURRENCE
$ 1,000,000
_
DAMAGE RN—T
PRE SESOEaEoccu ence
$ 1,000,000
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L
X
AGGREGATE LIMIT APPLIES PER:
POLICY D PRO-
JECT LOC
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
OTHER
A
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
90-18524-05 (AOS)
90-18524-06 (MA)
11/30/2015
11/30/2015
11/30/2016
11/30/2016
COMBINED SINGLE LIMIT
Ea accident
$ 1.000,000
BODILY INJURY (Per person)
_
$
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per accident)
$
HIRED AUTOS X NON -OWNED
AUTOS
X
PROPERTY DAMAGE
Per accident)$
$
C
X
UMBRELLA LIAB
XJ
OCCUR
9364-18 93
11/30/2015
11/30/2016
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5,000,000
EXCESS LIAB
_CLAIMS -MADE
DED RETENTION $
$
A
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? [
N / A
90-18524-01 (ADS)
g0-1852402 (WI)
11/30/2015
1113012015
11/30/2016
11130/2016
X IPER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$ 1,O1,000,000
E.L. DISEASE - EA EMPLOYEE
--
$ 1,000,000
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT I
$ 1,000,000
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 where required by written contract with respect to general and auto liabilities for
7516 Audit Services.
City of Fort Collins - Gerry Paul
215 N. Mason Street. 2nd Floor, PO Box 580
Fort Collins, CO 80522
I Iv1V
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
of Marsh USA Inc.
Keith A. Stiles 4�— ::g,�
v 19tltl-ZU14 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD