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HomeMy WebLinkAbout541897 HYLAND SOFTWARE INC - INSURANCE CERTIFICATE (2)HYLASOF-01 KUPA ACORN DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 1/2/2018 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 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). CONTACT PRODUCER (216) 367-8787 NAME: Erin A. Powers The James B. Oswald Company PHONE FAx IC No E,� :216-367-3295 A!C No 1100 Superior Avenue East E-MAIL Suite 1500 AODREss: epowers@oswaldcompanies.com Cleveland, OH 44114 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Federal Insurance Company 20281 INSURED HSI Holdings I, Inc. INSURERB:Great Northern Insurance Co. 20303 Hyland Software, Inc. INSURERC:Pacific Indemnity Company 20346 28500 Clemens Road INSURERD:Illinois National Ins Co 23817 Westlake, OH 44145- INSURER E : INSURER F : CnVFRA(;FS CFRTIFICATF N(1MRFR 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD MWDD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE X❑ OCCUR Y N 35783325 12/31/2017 12/31/2018 DAMAGE TO RENT =_9_ PREMISES Ea occurrence $ 1,000,00 MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 X POLICY PRO JECT 7 LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident, $ 1,000000 BODILY INJURY (Per person) $ B X ANY AUTO N N 73522883 12/31/2017 12/31/2018 ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS BODILY INJURY (Per accident) $ $ PROPERTY DAMAGE Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 A EXCESS LIAB CLAIMS -MADE N N '79882068 12/31/2017 12/31/2018 DED I X I RETENTION $ None $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY C IN ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ N 71713993 12/31/2017 12/31/2018 PER OTH X STATUTE ER E.L. EACH ACCIDENT Is 1,000,00 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA E.L. DISEASE - EA EMPLOYE $ 1,000,00 Ifg IP ribP,-nder DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 1,000,00 D Errors & Omissions Liab N N �043812576 12/31/2017 12/31/2018 Retention $500,000 Limit: $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins, its officers, agents and employees are included as Additional Insured if required by written contract for General Liability. 30 Day notice of cancellation will be given with respect to General Liability. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522- AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD