HomeMy WebLinkAboutIMAGE TREND INC - INSURANCE CERTIFICATE (2)DATE (MM/DDNYYY)
A`ORO® CERTIFICATE OF LIABILITY INSURANCE 6/13,2018
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 NTA T
NAME: Jenny Saylor
Associated Benefits and Risk Consulting PHONE g52-947-9700 AXAICNo : 952-947-9793
6000 Clearwater Drive E-MAIL
Minnetonka MN 55343 ADDRESS: IqMy.saylor@associatedbrc.com
INSURED IMAGEI3
ImageTrend, Inc.
20855 Kensington Blvd.
Lakeville MN 55044
INSURER A: Federal Insurance Company
INSURER B: Hartford Fire Insurance Corr
INSURER C: Hartford Casualty Insurance
INSURER D :
rnVFRAnFS rFRTIFICATF NtIMRFR- 74AnRnR73 REVISION NUMBER:
19682
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
SUER
POLICY NUMBER
POLICY EFF
MM/DD /YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
B
X
COMMERCIAL GENERAL LIABILITY
Y
Y
41UUNZT8493
6/152018
6/15/2019
EACH OCCURRENCE
$1,000.000
CLAIMS -MADE ExI OCCUR
DAMAGE TO
PREMISES EaENTED occurrr nce
$ 1,000,000
MED EXP (Any one person)
$15,000
PERSONAL & ADV INJURY
$1,000,000
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
GEN'L
POLICY ❑ PRO ❑ LOC
JECT
X
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
OTHER:
B
AUTOMOBILE LIABILITY
Y
Y
41UUNZT8493
6/152018
6/152019
COMBINED SINGLE LIMIT
Ea accident
$ 1,000000
BODILY INJURY (Per person)
$
X ANY AUTO
BODILY INJURY (Per accident)
$
ALL OWNED SCHEDULED
AUTOS
PROPERTY DAMAGE
Per accident
$
X NON -OWNED
X HIRED AUTOS AUTOS
C
X
UMBRELLA LIAB
X
OCCUR
Y
Y
41XHUZT339
6/152018
6/15/2019
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5,000,000
EXCESS LIAB
CLAIMS -MADE
E. FX RETENTION $ o
$
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY 1, I N
ANY PROPRIETOR/PARTNER/EXECUTIVE
Y
41 WEA86LMI
6/152018
6/152019
X I PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$ 500,D00
OFFICERIMEMBER EXCLUDED? ❑
N / A
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE
$ 5D0,000
E.L. DISEASE - POLICY LIMIT
$ 500, DDO
If yes, describe under
DESCRIPTION OF OPERATIONS below
B
A
Technology Prof!CyLw Liability
3rd Party Crime/Fidelity
Y
41TE0330029 18
82477411
6/152018
6/15/2018
6/152019
6/152019
Occ/Aggregate Limtt $5,000,000
Limit $500,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Network Security and Privacy Injury Liability are included in the Technology Errors & Omissions/Professional Liability. GENERAL LIABILITY - Blanket
Additional Insured, Primary/Non-Contributory and Waiver of Subrogation (Endorsement #HC00010916); COMMERICAL AUTO - Blanket Additional Insured,
Primary -Non -Contributory, Waiver of Subrogation (Endorsement #HA99160212); WORKERS COMPENSATION Blanket Waiver of Subrogation (Endorsement
#000313) as required by written agreement or contract.
City of Fort Collins and Poudre Fire Authority are Additional Insured as required by written contract or agreement.
Poudre Fire Authority
102 Remington St
Fort Collins, CO 80524
r`CATIFIr`ATC Wni 111=0 rANrFl I ATION
RECEIVED
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Fort Collins
300 LaPorte Ave
Fort Collins CO 80521
JUN 19 2018
AUTHORIZED REPRESENTATIVE
V lyt$tf-ZUl4 AcvrtU L,UKYUKA I IVN. All rlgnis reservea.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD