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HomeMy WebLinkAbout567622 RSM US LLP - INSURANCE CERTIFICATE (6)'A�U,RL7® CERTIFICATE OF LIABILITY INSURANCE ATE D11/29/201r7Drvvvv) 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,.--- Marsh USA Inc. 2405 Grand Boulevard, #900 A/o _No, Extl. _ -_ --_ _... 1_WCC NO). _ Kansas City, MO 64108 E-MAIL Attn: KansasCity.CertRequest@marsh.com Fax: 212-948-0015 ADDRESS_ INSURERS AFFORDING COVERAGE NAIC # INSURER A : Sentry Insurance A Mutual Company 24988 102813 REastm INSURED RSM US LLP INSURER B : Sentry Casualty Company 28460 INSURER C : Federal Insurance Company 20281 One South Wacker Drive, Suite 800 Chicago, IL 60606 INSURER D INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: CHI-007154319-11 REVISION NUMBER: 10 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 SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY) POLICY EXP (MMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE E OCCUR 90-18524-04 11/30/2017 11/30/2018 EACH OCCURRENCE $ 1,000,000 DAM" PMISES ,RENT PREEa occurrence $ 1,000,000 MED EXP (Any one person) $ 10,000 _ AGGREGATE LIMIT APPLIES PER. POLICY PRO ❑ JECT LOC OTHER PERSONAL & ADV INJURY $ 1,000,000 GEN'L X GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY 90-18524-06 11/30/2017 11/30/2018 COMBINED SINGLE LIMIT (Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 9364-18-93 11/30/2017 11/30/2018 EACH OCCURRENCE $ 5,600,000 AGGREGATE $ 5,000,000 DE D RETENTION $ $ A g WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NI (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 90-18524-01 (ADS) 90-18524-02 WI ( ) 11/30/2017 11/30/2018 11/30/2018 X PER 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 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Fort Collins, its officers, agents and employees are included as additional insured where required by written contract with respect to general and auto liabilities for 7516 Audit Services, GtK I It-IGA 1 t t1OLUtK GANGELLATION City of Fort Collins - Gerry Paul 215 N. Mason Street, 2nd Floor, 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. Keith A. Stiles ofsv� ,,�_ :g4� ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD