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HomeMy WebLinkAbout102630 AYRES ASSOCIATES INC - INSURANCE CERTIFICATE (13)AC� ® DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE F,2/19/2017 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 endorsements . PRODUCER CONTACT NAME: Sharon Bannach Arthur J. Gallagher Risk Management Services, Inc. PHONE 262 792 2214 FAXC. Nol,262 792 1712 245 South Executive Drive, Suite 200 E-MAIL Brookfield WI 53005 . Sharon_Bannach@ajg.com INSURED AYRES ASSOCIATES INC 3433 Oakwood Hills Parkway Eau Claire, WI 54702-1509 AYREASS-02 INSURER A: Travelers Property Casualty Co of America 125674 INSURER B:The Travelers Indemnity Company of CT 125682 D r17\/FDARFC CFDTIFIrATG R111MRCA- 19601864Ari DPIIIQlrl1U PitlunGD- 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 DLTSUBR POLICY EFF -POLICY EXP _ LTR ' TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE XI OCCUR Y P6302183P260TIA18 111/2018 1/1/2019 EACH OCCURRENCE $1,000,000 AMAGE TO RENTED PREMISES Ea occurrence $100,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PO- POLICY 7 JECT E LOC OTHER: GENERAL AGGREGATE $2,000,000 X PRODUCTS - COMP/OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY Y P8103790P125TIL18 1/1/2018 1/1/2019 COMBINED b=E LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident) $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS MADE PSMCUP3790P149TIL18 1/1/2018 1/1/2019 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 DIED I X I RETENTION $0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y /N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA UB91­1943775018 1/1/2018 1/1/2019 X P OTH- STATUTE ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 7 1 i DESCRIPTION OF OPERATIONS / 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 for General Liability per form CGDO 37 0405 and Auto Liability per form CAT3 53 031 CERTIFICATE HOLDER CANCELLATION The City of Fort Collins Purchasing Department PO Box 580 Fort Collins CO 80522 USA 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 REPRESENTT1VE VVIP I0 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD