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HomeMy WebLinkAbout585120 CODE 4 SECURITY SERVICES LLC - INSURANCE CERTIFICATECODE4-1 OP ID: P5 '4�vRo CERTIFICATE OF LIABILITY INSURANCE 704/13/2018 /YYYY) 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 Brown 8r Brown Inc NAME: Kdren Siwek -- - 4532 Boardwalk Dr, Suite 200 A/C. No Ell: 970-482-7747 FAAic, No): 970-484-4165 Fort Collins, CO 80525 E-MAIL Karen E. Siwek, CPA -ADDRESS: ksiwek@bbcolorado.com INSURER A: Underwriters at Lloyds London 23221 INSURED Code 4 Security Service, LLC INSURER B: Pinnacol Assurance Company 41190 1001 E Harmony Road, Ste A-21 INSURER c : Berkshire Hathaway Homestate 20044 Fort Collins, CO 80525 INSURER D : INSURER E: INSURER F : COVFRAGFS CFRTIFICATF NIIMRFR- RFVISION NI IMRFR- 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 TYPE OF INSURANCE ADDL UBR - -- -- �- POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE _X OCCUR MPL1950913.18 04/11/2018 04/11/2019 DAMAGE TO RENTED PREMISES Ea occurrence $ 50,00 MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY a PRO- ❑ JECT LOC PRODUCTS -COMP/OP AGG $ 2,000,00 $ OTHER: AUTOMOBILE LIABILITY CEa OMBINED SINGLE LIMIT a ccident $ 1, , 000 000 BODILY INJURY (Per person) $ C ANY AUTO 05APM015819-01 01/26/2018 01/25/2019 ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X X NON -OWNED HIRED AUTOS AUTOS MPL1950913 HNOA PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,00 X AGGREGATE $ 1,000,00 A EXCESS LIAB CLAIMS -MADE WCIS-CEL-0000225-02 08/30/2018 04/11/2019 DED X RETENTION $ 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 4200933 04/21/2018 06/01/2019 X PER OTH- STATUTE ER 1 E.L. EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A E.L. DISEASE - EA EMPLOYEE $ 1,000,00 It yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 000,00 $ , A Prof Liability MPL1950913.18 04/11/2018 04/11/2019 Per Claim 1,000,00 Claims Made Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City Of Fort Collins is included as Additional Insured per policy forms and conditions on page 2. CERTIFICATE HOLDER CANCELLATION CITFORT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Marissa Donegon P. O Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 Karen E. Siwek, CPA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD CODE4-1 PAGE 2 NOTEPAD INSURED-S NAME Code 4 Security Service, LLC OP ID: P5 Date 04/13/2018 When Require by written contract the following applies: Commercial General Liabilty Blanket Additional Insured (WCL P002 CW) Blanket Waiver of Subrogation (WCL P002 CW) Primary 6 Non -Contributory - (WCL P0002 CW) Commercial Auto: Hired Autos and Non -Owned Autos MPL1950913.18 4.11.18-4.11.19 Professional Liability Blanket Additional Insured (WCLMPL 0010 CW) Blanket Waiver of Subrogation (WCLNPL 0010 CW) kers Compensation nket Waiver of Subrogation 359-B ss - owing Form