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HomeMy WebLinkAboutCONVERGINT TECHNOLOGIES LLC - INSURANCE CERTIFICATE (2)_ Page 1 of 1 ACoR" CERTIFICATE OF LIABILITY INSURANCE D02/20/2018Y) 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 CONTACT NAME: Willis of Illinois, Inc. PHONE FAX A/ No xt: 1-877-945-7378 A/C No: 1-888-467-2378 c/o 26 Century Blvd E-MAIL P.O. Box 305191 ADDRESS: certificates@willis.com Nashville, TN 372305191 USA INSURER(S) AFFORDING COVERAGE NAIC# RECEIVED INSURERA: XL Insurance America, Inc 24554 INSURED Convergint Technologies LLC #350 �� 2U�V Location #350 One commerce Drive Schaumburg, IL 60173 City Manager's Offic INSURERB: Navigators Insurance Company 42307 INSURERC: XL Specialty Insurance Company 37885 I INSURER D: INSURERE: r`r1VFRAr;FC CFRTIFICOTF NIIMRI=R- W5320826 REVISION NLIMRFR:v- 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 ADOLTYPE INSD WVDI SUER, POLICY NUMBER MM/DDPOLICY EFF MM/DPOLDn YP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE -UA-MAGE $ 1,000,000 F�71 CLAIMS -MADE OCCUR TO RENTED PREMISES Ea occurrence) $ 300,000 MED EXP (Any one person) $ 10,000 A Y CGS740905406 03/01/2018 03/01/2019 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ECT � LOC PRODUCTS - COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS CAH740002407 03/01/2018 03/01/2019 BODILY INJURY Per accident ( ) $ HIRED NON -OWNED X AUTOS ONLY EXAUTOS ONLY PROPERTY DAMAGE Per accident)$ B UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 X AGGREGATE $ 4,000,000 EXCESS LIAB CLAIMS -MADE CH18EXC704521IV 03/01/2018 03/01/2019 DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY AND Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED, No (Mandatory in NH) N/A CWG740002207 03/01/2018 03/01/2019 X ER E.L. EACH ACCIDENT _ $ 11000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 If yes, describe under UESCRIPTIUN OF UPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Project #350FNF074 / 10-01245 Eye Care Center of Northern Colorado. City of Fort Collins is included as an Additional Insured as respects to General Liability as required by written contract. CERTIFICATE HOLDER CAN(:tLLA I IUN City of Fort Collins 300 LaPorte Avenue Fort Collins, CO 80521 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 L k111c---TCvuC1' ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 15664482 BATCH: 609757