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HomeMy WebLinkAboutREPORTING SYSTEMS INC DBA EMERGENCY REPORTING - INSURANCE CERTIFICATEA� Q® 715/31/2018 E(MM1DD YYYY) CERTIFICATE OF LIABILITY INSURANCE 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). Feln CONTACT NAME: Scott FIueroa ernational Northwest LLC PHONE FAILytreet E-NIANo, X : 360-647-9000 A/cNo : 360-734-8496 am WA 98225 ADDRESS: now-bellinghaminfo@hubinternational.com INSURED Reporting Systems, Inc. DBA Emergency Reporting 2200 Rimland Drive, Ste. 305 Bellingham WA 98226 INSURERS AFFORDING COVERAGE NAIC # _ INSURER A: Sentinel Insurance Company, Ltd. 11000 REPOSYS-01 INSURER B : Hartford Accident and Indemnity Company 22357 INSURER c : Hartford Fire Insurance Company 19682 INSURER D : CnVFRAAFS CERTIFICATE NUMBER:444433288 REVISION NUMBER: 1 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 OF INSURANCE ADDLTYPE INSO SUER POLICY NUMBER MM/DDY EFF MM DDY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 52SBAAB1503 6/1/2018 6/1/2019 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 2,D0o,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY F—1 PRO ❑ LOC X JECT PRODUCTS - COMP/OP AGG $ 4,D00,000 $ OTHER: B AUTOMOBILE LIABILITY Y Y 52UECHC1043 6/112018 6/1/2019 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS PROPERTY DAMAGE Per accident $ X X NON -OWNED HIRED AUTOS AUTOS A X UMBRELLA LIAB X OCCUR 52SBAAB1503 6/1/2018 6/1/2019 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 EXCESS LIAB CLAIMS -MADE DED X RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y / N ANY PROPRIETOR/PARTNERIEXECUTIVE STATUTE X ER Stop Gap $ 1,000,000 E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? ❑ N /A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT If yes, describe under DESCRIPTION OF OPERATIONS below $ 1 000,000 C Technology Liability 52TE0329807 6/1/2018 6/1/2019 Each Wrongful Act 1,000,000 Aggregate 1,000,000 Retention 5,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Per forms and conditions: Additional Insured and Waiver of Subrogation are included in the following forms, Business Liability Coverage form SS 00 08 04 05; Auto Broad Form Endorsement HA 99160312. City of Fort Collins its officers, agents and employees are additional insureds per forms and conditions. rCDTIl7Ir ATC L.Ini 119:10 rANrFI I ATInNI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins, on behalf of the Poudre Fire Authority ACCORDANCE WITH THE POLICY PROVISIONS. 215 N. Mason St. 2nd Floor AUTHORIZED REPRESENTATIVE P.O. Box 580 Fort Collins CO 80522 �- © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD