HomeMy WebLinkAbout102630 AYRES ASSOCIATES INC - INSURANCE CERTIFICATE (16)AYREASS-01 CTHOMPSON
CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
6/20/2017
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).
CONTACT
PRODUCER NAME: _ _
Johnson Insurance Madison AX
a/CO, o EXa (800) 776-7055 LAIC No): (877) 254-8586
525 Junction Road E-MAIL
Madison, WI 53717 ADDREss: info@johnsonins.com
INSURER(S) AFFORDING COVERAGE NAIC N
INSURERA:RLI Insurance Company 13056
INSURED INSURER B :
Ayres Associates Inc INSURERC:
3433 Oakwood Hills Pkwy INSURERD:
Eau Claire, WI 54701 INSURERE:
INSURER F
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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 ADDL`SUBR POLICY EFF POLICY EXP LIMITS
VIVIDLTR TYPE OF INSURANCE IN DVIVIDPOLICY NUMBER IMYYYJ I (MMIDIDNY
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
EACH OCCURRENCE
$
-DAM—AGE-TD-R
PREMISES Ea occurrence
$
MED EXP (Any one person)
$
PERSONAL& ADV INJURY
$
GENERAL AGGREGATE
$
GENT AGGREGATE LIMIT APPLIES PER:
POLICY ❑ PRO ❑ LOG
JECT
PRODUCTS - COMP/OP AGG
$
$
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$
BODILY INJURY (Per person)
$
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
HIRED AUTOS AUTOS
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE $
EXCESS LIAB
CLAIMS -MADE
AGGREGATE $
DIED R
COMPENSATION
H-
STATE ER
UWORKERS
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? ❑
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
Professional Liab
Professional Liab
NIA
RDP0029291
RDP0029291
06/30/2017
06/30/2017
E.L. DISEASE - EA EMPLOYEE $
E.L. DISEASE - POLICY LIMIT $
06/30/2018 Each Claim 5,000,000
06/30/2018 jAggregate 10,000,000
A
A
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
GtK I It -ILA I C MULUCK
City of Fort Collins
215 N Mason St
Fort Collins, CO 80524
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
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ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD