HomeMy WebLinkAbout433338 RUSSELL + MILLS STUDIO - INSURANCE CERTIFICATE (2)RUSSE-1 OP ID: CK
,4coRa► CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY►
`—� 06/21 /2018
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND ^^�iccoc un or�uTc rrnnu Tur IQOT!►1/+�TC un! 11r� TIJIQ
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEN4_'-"__-
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT UETa; EEEs
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 terns 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 endorsements .
PRODUCER
PO Box 3412 f Colorado, Inc
NAMEA T Cindy L. Kin
(AIC.PHONE : 720-465-9116 FAX No): 248-553-8305
ADDRESS- AIL
SS: cking@,profunderwriters.com
Littleton, CO 80161-3412
Cindy L. King
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A:Navigators Insurance Company
42307
INSURED Russell + Mills Studios
INSURER B : Hartford Ins. of the Midwest
37478
506 S. College, Unit A
Fort Collins, CO 80524
INSURER C: Travelers Indemnity Company
25658
INSURER D :
INSURER E :
INSURER F :
COVERAGES
CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED i v Ti [ = _ „
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT Wt i ri RESPE:, i 1 v '..HICH 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
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MMIDD/YYYY
LIMITS
C
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE XOCCUR
680-8K396362-18-47
05/29/2018
05/29/2019
EACH OCCURRENCE
$ 1,000,00
PTO RENTE5__
REMISES Ea occurrence
$ 1,000,00
MED EXP (Any one person)
$ 6,00(
PERSONAL & ADV INJURY
$ 1,000,00
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY ❑ PRO- ❑
JECT LOC
OTHER:
GENERAL AGGREGATE
$ 2,000,00
PRODUCTS-COMP/OPAGG
$ 2,000,00
$
C
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
X HIRED AUTOS LAUTOS
680-8K396362-18-47
05/29/2018
06/29/2019
COMEa aBINED SINGLE LIMIT ccident
$ 1,000,000
�
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
er accident
(per.
$
$
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
DED I I RETENTION $
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
3SWEC112813
02/04/2018
02/04/2019
XOTH-
STATUTE ER
E.L. EACH ACCIDENT
$ 11000100
E.L. DISEASE - EA EMPLOYEE
$ 1,000,00
E.L. DISEASE - POLICY LIMIT
I $ 1,000,00
A
Professional Liab
DN17DPLO191311V
09/15/2017
09115/2018
Ea Claim 2,000,00
Aggregate 2,000,00
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
FTCOLCI
City of Fort Collins
PO 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
01988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD