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HomeMy WebLinkAbout104254 GALLS INC - INSURANCE CERTIFICATEPage 1 of 1 ACO, RE® ` CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 03/14/2018 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 Willis of New York, Inc. c/o 26 Century Blvd P.O. Box 305191 CONTACT NAME: PHONE 1-877-945-7378 FAX 1-888-467-2378 A/C No Ext : A/C No): EMAIL ADDRESS: certificates@willis.com INSURERS AFFORDING COVERAGE NAIC# Nashville, TN 372305191 USA INSURER A: QBE Insurance Corporation 39217 INSURED INSURERB: General Casualty Company of Wisconsin 24414 Galls, LLC 1340 Russell Cave Rd. INSURER C: Praetorian Insurance Company 37257 INSURER D : Lexington, ICY 405053114 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: W5498168 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. INSR LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MM/DDY EFF � MOLIC EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 F;Z;7-1 CLAIMS -MADE OCCUR DAMAGE INTID PREM SES� a occurrence) ccurrence $ 1,000,000 MED EXP (Any one person) $ 10,000 A y CGA1331044 03/01/2018 03/01/2019 PERSONAL& ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2 , 000 ; 000 POLICY ❑ PET LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY 71 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO - A . -- - OWNED SCHEDULED AUTOS ONLY AUTOS y CRA1331044 03/01/2018 03/01/2019 BODILY INJURY (Per accident) $ HIRED NON -OWNED EPROPERTY AUTOS ONLY AUTOS ONLY DAMAGE Per accident $ B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE CCU1331044 03/01/2018 03/01/2019 X DED RETENTION $ 10, 000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N OFFI CER/MEMBER EXCLUDED? (Mandatory In NH) N/A CWC1331044 03/01/2018 03/01/2019 TH- X STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) This Voids and Replaces Previously Issued Certificate Dated 03/13/2018 WITH ID: W5496085. Contract# 8085 Police Uniforms City of Fort Collins is included as an Additional Insured as respects to General Liability and Auto Liability. 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. AUTHORIZED REPRESENTATIVE City of Fort Collins 215 N. Mason St. 2nd Floor Fort Collins, CO 80522 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD SR ID: 15772469 BATCH: 634708