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HomeMy WebLinkAbout532500 TOOLE DESIGN GROUP LLC - INSURANCE CERTIFICATE (2)CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)12/14/2015 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 CONTACT NAME: Klein Agency, LLC. A/�NNo 6t: (410)832-7600 FAX No: (410)832-1849 E-MAIL ADDRESS: P.O. Box 219 INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:Nati.onal Surety Co Timonium MD 21094 INSURED INSURER B American Automobile Ins. Co. INSURER C :Trumbull Insurance Co. Toole Design Group, LLC INSURERD:Continental Casualty Company_ 8484 Georgia Avenue, Suite 800 INSURER E : Silver Spring MD 20910-5609 INSURER F: COVERAGES CERTIFICATE NUMBER:16-17 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 SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY), POLICY EXP (MM/DDNYYYI LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A CLAIMS -MADE X OCCUR DAMAGE( RENTED PREMISESSEa occurrence $ 1,000,000 X MED EXP (Any one person) $ 10,000 Contractual Liability ABC80908293 1/1/2016 1/1/2017 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY JERCOT -- LOC PRODUCTS -COMP/OP AGG $ 4,000,000 Employee Benefits $ 1,000,000 OTHER* AUTOMOBILE LIABILITY CEaOMI acBcNideDtESINGLE LIMIT n $ 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS MKA80316124 rID 1/1/2016 1/1/2017 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS MXA80316126 VA X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 2,000,000 A EXCESS LIAB CLAIMS -MADE UMBRELLA FOLLOWS FORM DED I I RETENTION$ $ ABC80908293 1/1/2016 1/1/2017 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE C OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A 30WECCN9232 1/1/2016 1/1/2017 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 D 'Professional Liability MCH591868957 1/1/2016 1/1/2017 Per Claim $2,000,000 Aggregate $2 , 000 , 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: 7559 Bike Plan Update and TDG Project # B001 30 days notice of cancellation is provided, 10 days for non-payment. See attached for specific additional insured wording. City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 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 Justin Klein/LINDA ACORD 25 (2014/01) INS025 (201401) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMENTS/REMARKS If required under an insured written contract, executed prior to any loss, City of Fort Collins is an Additional Insured under the General Liability Policy, but only with respects to liability arising from work performed by or on behalf of Toole Design Group, LLC. If required under an insured written contract, executed prior to any loss, City of Fort Collins is an Additional Insured under the Automobile Policy, but only with respects to liability arising from the operation of vehicles by employees of Toole Design Group, LLC. If required under an insured written contract, executed prior to any loss, Waiver of Subrogation is provided for City of Fort Collins under the General Liability, Automobile Liability and Workers Compensation Policies. It is further understood that coverage provided the Additional Insured under the General Liability and Automobile Liability shall be primary and non-contributory to any other coverage available to the Additional Insured. L OFREMARK COPYRIGHT 2000, AMS SERVICES INC. '