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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: ., nori�n�n�o nrencil Rj IUIIIIALMD• 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