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HomeMy WebLinkAboutTHE MCINTOSH GROUP LLC - INSURANCE CERTIFICATE (3)A`OROF CERTIFICATE OF LIABILITY INSURANCE
TE YY)
DA2/13/216
016
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
CONTACT
NAME: Melissa Pratt
McLaughlin Brunson Insurance Agency, LLP
PHONE FAX
12801 North Central Expressway
A/C No Ext: (214) 503-1212 A/C No:(214) 503-8899
E-MAIL
ADDRESS:
Suite 1710
Dallas TX 75243
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: Berkley Insurance Company
32603
INSURED (918) ses-esss
INSURERB: Phoenix Insurance Company
25623
The McIntosh Group, LLC
INSURER C: Charter Oak Fire Insurance Co
25615
INSURER D: Travelers Indemnity Company
25658
1850 South Boulder Avenue
Suite 300
INSURER E: Hartford AccidentSIndemnity Co
22357
Tulsa OK 74119
INSURER F :
COVERAGES CERTIFICATE NUMBER: Cert ID 31678 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
WVD
POLICY NUMBER
POLICY EFF
MM/DDNYYY
POLICY EXP
MM/DDNYYY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 2,000,000
B
X COMMERCIAL GENERAL LIABILITY
Y
y
6804F980649
2/2/2016
2/2/2017
DAMAGE TO RENTED
PREMISES Ea occurrence
$ 1,000,000
CLAIMS -MADE FxI OCCUR
MED EXP (Any one person)
$ 5,000
PERSONAL BADVINJURY
$ 2,000,000
GENERAL AGGREGATE
$ 4,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 4,000,000
POLICY X JEOT LOC
$
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
BODILY INJURY (Per person)
$
C
ANY AUTO
Y
Y
BA4F980902
2/2/2016
2/2/2017
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per accident)
$
X
NON -OWNED
HIRED AUTOS X AUTOS
PROPERTY DAMAGE
Per accident
$
D
X
UMBRELLA LIAB
X
OCCUR
Y
Y
CUP4F982514
2/2/2016
2/2/2017
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$ 1,000,000
CESS LIAB
CLAIMS -MADE
DED I I RETENTION $
$
E
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y/ N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? N❑
N/A
Y
46WECAN5017
2/2/2016
2/2/2017
X I WC STATU- OTH-
TCRYLIMITI ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
(Mandatory in NH)
if yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
A
Professional Liability
Y
AEC-9003929-01
7/6/2015
7/6/2016
Per Claim/Annual $ 2,000,000
Aggregate
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
The claims made professional liability coverage is the total aggregate limit for all claims
presented within the annual policy period and is subject to a deductible. Thirty day notice of
cancellation in favor of the certificate holder on all policies. The City, its officers, agents and
employees are named as additional insureds on the general and auto liability coverages as required
by contract. RE: Ft. Collins ADA RFP
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
Purchasing Division
AUTHORIZED REPRESENTATIVE
215 N. Mason St. 2nd Floor
PO Box 580
Fort Collins CO 80522
ACORD 25 (2010105)
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The ACORD name and logo are registered marks of ACORD