HomeMy WebLinkAbout102630 AYRES ASSOCIATES INC - INSURANCE CERTIFICATE (15)I a DATE (MM1DD/YYYY)
AcoR" CERTIFICATE OF LIABILITY INSURANCE 12/22/2016
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
Arthur J. Gallagher Risk Management Services, Inc.
17035 W Wisconsin Ave., Suite 135
Brookfield WI 53005
INSURED
AYRES ASSOCIATES INC
3433 Oakwood Hills Parkway
Eau Claire, WI 54702-1509
AYREASS-02
Sharon Bannach
-rt1. 262-792-2214 _ aC, Not: 262 792 1712
Sharon_Bannach@ajg.com
INSURER(S) AFFORDING COVERAGE NAIC #
A:Travelers Property Casual CO of A 25674
B:Travelers Indemnity Co of America 25666
c:The Travelers Indemnity Company of 25682
D:
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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 ADDC POLICY EFF POLICY EXP LIMITS
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIODNYYY MWDD(YYYY
B
X
COMMERCIAL GENERAL LIABILITY
Y
P6302183P260TIA17
1/1/2017
1/1/2018
EACH OCCURRENCE
$1,000,000
Pr PREMISES EAO RFocc urrence
$100,000
CLAIMS -MADE X OCCUR
$10,000
MED EXP (Any one person)
$1,000,000
PERSONAL & ADV INJURY
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$2,000,000
PRO_OUCTS - COMP/OP AGG
$ 2,000,000
X POLICY JE O LOC
$
OTHER:
A
AUTOMOBILE LIABILITY
X ANY AUTO
Y
P810379OP125TIL17
1/1/2017
1/1/2018
COMBINED SINGLE
Ea accident
$1,000,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
OWNED SCHEDULED
AUTOS ONLY AUTOS
Per accident)
$
X HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
A
X
UMBRELLA LIAB
OCCUR
PSMCUP379OP149TIL17
1/1/2017
1/1/2018
EACH OCCURRENCE
$5,000,000
��X
AGGREGATE
$5,000,000
EXCESS LIAB
CLAIMS -MADE
DED I X , RETENTION$0
$
A
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY y /N
ANY PROPRIETOR/PARTNER/EXECUTIVE a
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
N/A
PJUB252BP88117
PDTSEUB2522P94417
1/1/2017
1/1/2017
1/1/2018
1/1/2018
X STATUTE ERH
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE - EA EMPLOYE
$500,000
E.L. DISEASE - POLICY LIMIT
$500,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
The City of Fort Collins is included as Additional Insured for General Liability per form CGDO 37 0405
and Auto Liability per form CAT3 53 0310.
I-II:AI It HULL)tK
The City of Fort Collins
Purchasing Department
PO Box 580
Fort Collins CO 80522
USA
V /'1f IIV LLLfl1 IV 1\
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
e)e . ,
V I Vt$t$-LU I S AL L)KLJ k t.)KYVKra I MANI. nu I lynta I UZIVI Vcu.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD