HomeMy WebLinkAbout102499 ADT SECURITY SERVICES - INSURANCE CERTIFICATE (2)® CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
09/28/2017
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 endorsement(s).
PRODUCER CONTACT
Marsh USA Inc. NAME:
1560 Sawgrass Corporate Pkwy, Suite 300 PHC NE FAX No
Sunrise, FL 33323 E-MAIL
Attn: FtLauderdale.Certs@marsh.com ADDRESS:
048953-ADT-GAW-17-18 _ INSURER A: ACE American Insurance Company 22667
INSURED ADT LLC dba Protection One INSURER B : ACE Fire Underwriters Insurance Company 20702
7808 Cherry Creek South Drive, Suite 113 INSURER C :
Denver, CO 80231 INSURER D :
INSURER E :
INSURER F :
COVFRAGFS CFRTIFICATF NUMBER- ATL-004399374-05 REVISION NUMBER- 0
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
ADDLSUBRTYPE
INSD
WVD
POLICY NUMBER
MM POLICY EFF
/DD/YYYY
POLICY EXP
MM/DD YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
XSL G2787115A
10/01/2017
10/01/2018
EACH OCCURRENCE
$ 2,000,000
CLAIMS -MADE � OCCUR
TED
PREMISES (Ea DAMAGE TO occurrence)
$ 1,000,000
X
MED EXP (Any one person)
$
SIR: $500,000
PERSONAL & ADV INJURY
$ 2,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER
GENERAL AGGREGATE
$ 4,000,000
POLICY PRO LOC
JECT
X
PRODUCTS - COMP/OP AGG
$ 4,000,000
$
OTHER.
A
AUTOMOBILE LIABILITY
ISA H09063304
10/01/2017
10/01/2018
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
BODILY INJURY (Per person)
$
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
$
UMBRELLA LIAB
_ _
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DIED I I RETENTION $
$
A
g
WORKERS COMPENSATION
AND EMPLOYERSLIABILITY
' YIN N
ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? N
(Mandatory in NH)
N/A
WLR C64618763 (ADS)
SCF C64618775 (WI)
10/01/2017
10/01/2018
1010112018
X PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$ 2,000,000
E.L. DISEASE - EA EMPLOYEE
$ 2,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E L DISEASE - POLICY LIMIT
$ 2,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Professional Liability is included under the General Liability policy subject to the policy provisions.
CERTIFICATE HOLDER
City of Fort Collins
PO Box 580
Fort Collins, CO 80522
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
of Marsh USA Inc.
Vincent Zollo
@ 1988-2016 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD