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HomeMy WebLinkAbout309950 T2 SYSTEMS INC - INSURANCE CERTIFICATE (11)Page 1 of 1 ACORD® CERTIFICATE OF LIABILITY INSURANCE _DATE /31/2" 7"' 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 Willis of Michigan, Inc. c/a 26 Century Blvd P.O. Box 305191 CONTACT NAME: PHOfAIC'NE FAX -- No Ext: 1-877-945-7378 A/C No: 1-888-467-2378 E-MAIL - ADDRESS: certificates@villis.com INSURERS AFFORDING COVERAGE NAIC# Nashville, TN 372305191 USA INSURERA: StarNet Insurance Company 40045 INSURED T2 Systems, Inc. 8900 Keystone Crossing Suite 700 INSURERS: Berkley Insurance Company 29580 INSURERC: Berkley National Insurance Company 38911 INSURERD: AXIS Insurance Company 37273 Indianapolis, IN 46240 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: W4234431 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 LTR TYPE OF INSURANCE ANDDL SOU /BRI POLICY NUMBER MM DIDIYYYYJ Y EFF POLICY MMDDP LIMITS x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE x � OCCUR DAMAGE(RENTED PREMISESS Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 10,000 A Y TCP 7007311-12 10/31/2017 10/31/2018 PERSONAL & ADV INJURY $ 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 JECT POLICY PRO ❑ LOC PRODUCTS -COMP/OPAGG $ 2,000,000 --- $ OTHER: AUTOMOBILE LIABILITY MBINEDSINGLE LIMIT acc (CEO, ident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO p, OWNED SCHEDULED AUTOS ONLY AUTOS Y TCP 7007311-12 10/31/2017 10/31/2018 BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident - $ _ $ B x UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10,000,000 EXCESS LIAB CLAIMS -MADE TUL 7007372 10/31/2017 10/31/2018 DED FX7RETENTION$ 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N/A TWC 7007313-12 10/31/2017 10/31/2018 x PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 D Security Liability/ ECN000249581701 10/31/2017 10/31/2018 Occur./Aggr. $10,000,000 �Cyber Professional Liability Retroactive Date: 1/1/2004 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) The City of Fort Collins, CO is added as an Additional Insured as respects the General Liability and Liabilitys. UrK I IrIUA 1 r I IULUrK GANL LLLA I IUN City of Fort Collins 215 North Mason P.O. 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 REPRESEN�yTpATIVE Q,x+. ,Al © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 15262064 BATCH: 497812