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HomeMy WebLinkAboutCARRIER CORPORATION - INSURANCE CERTIFICATE (11)1-2 , � 141 CERTIFICATE OF LIABILITY INSURANCE �� DAT3/22/2018 ) 03/22/2018 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 have ADDITIONAL INSURED provisions or 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 MARSH USA INC. 20 CHURCH STREET CONTACT NAME. PHO N FAX No): E-MAIL ADDRESS: HARTFORD, CT 06103 INSURERS AFFORDING COVERAGE NAIC # INSURER A:Hartford Fire Insurance Company 19682 INSURED CARRIER CORPORATION INSURER B :National Union Fire Insurance Company of Pittsburgh, PA 19445 INSURER C :New Hampshire Insurance Company 23841 17900 BEELINE HIGHWAY JUPITER, FL 33478 INSURER D :American Home Assurance Company 19380 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:3KYA22BJ REVISION NUMBER: 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. TR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM DDY/YYYY) (MMI LIMITS A X COMMERCIAL GENERAL LIABILITY 02CSET10004 04/01/2018 04/01/2019 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE [K] OCCUR $2,000,000 general aggggregate per location/project $10,000,000 policy general aggregate PREMISES H occurrence $ 30Q000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY ❑ PRO- ❑ LOC JECT PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER' A AUTOMOBILE LIABILITY 02CSET10000 (A/O) 02CSET10019 HI) 04/01/2018 04/01/2019 COMBINED SINGLE LIMIT Ea accident 1.000,000 )( BODILY INJURY (Per person) $ ANY AUTO Hartford Underwriters Ins OWNED SCHEDULED AUTOS ONLY AUTOS 1 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY A X UMBRELLA LIAB X OCCUR 02HUT10021 04/01/2018 04/01/2019 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 EXCESS LAB CLAIMS -MADE DED I I RETENTIONS $ B C D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) N / A CT WC(SIR 2.5MM)EX COV- 6583040 CA-015519205 FL-015519206, MA-015519212 MN-015519208, MULTI-015519204 04/01/2018 04/01/2019 X PER OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 ifyc:, dcscr;beundcr DESCRIPTION OF OPERATIONS below MULTI-015519207,MULTI- 015519211 E.L. DISEASE - POLICY LIMIT $ 1,000,000 $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CONTRACTORS LICENSE CERTIFICATE HOLDER CANCELLATION 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 AUTHORIZED REPRESENTATIVE P.O. BOX 580 FORT COLLINS, CO 80522 0 '010217/1--S O--B 0--D 010217 Page 1 of 1 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD