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HomeMy WebLinkAbout548927 SKC COMMUNICATION PRODUCTS LLC - INSURANCE CERTIFICATE (8)ACo ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) �� 10/25/2017 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 endorsements . PRODUCER CONTACT NAME: Aubrey Meyer Arthur J. Gallagher Risk Management Services, Inc. PHONE . 816-395-8593 FAX . 816-467-5593 2345 Grand Blvd., Suite 400 Kansas City MO 64108 E-MAIL . aubrey_meyer@ajg.com INSURERS AFFORDING COVERAGE NA INSURER A: Travelers Property Casualty Co of America 25674 INSURED INSURER B: Charter Oak Fire Insurance Compaq25615 SKC Communication Products, LLC INSURER c: Standard Fire Insurance Company 19070 8320 Hedge Lane Terrace Shawnee Mission, KS 66227 INSURERD: INSURER E n0VFDAnFR CFDTIFICATF IUI IMRFD- 109277.5295 DFL/1¢ICVd fdl IRARFD• 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. IMSR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE I D WVD POLICY NUMBER MMIDD/YYYY MWYDD/YYYY LIMITS B X COMMERCIAL GENERAL LIABILITY 630-4C660679-COF-17 11/1/2017 11/1/2018 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR �._. _ — AGl"TO RENTE6 pREMISESiEaoccurrence — E1,000,000 MED EXP (Any one person) E 10,000 PERSONAL & AD_V INJURY $1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: � GENERAL AGGREGATE $2,000,000 POLICY jEO- F7 LOC PRODUCTS - COMPIOP AGG $2,000,000 E OTHER: A AUTOMOBILE LIABILITY BA-4C663910-17-TEC 11/1/2017 11/1/2018 Ea_accideM) E 1,000,000 BODILY INJURY (Per person) E X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY X BODILY INJURY (Per accident) E ROPEPTY-DA1VfAGE— E E A X UMBRELLA LIAB X OCCUR HSM-CUP-OK57144A 11/1/2017 11/1/2018 EACH OCCURRENCE $7,000,000 AGGREGATE $7,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION E 10000 — E C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBEREXCLUDED? N N/A HF-UB-7J914884 11/1/2017 11/1/2018 X P R OTH- STATUTE ER E.L. EACH ACCIDENT E1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) It yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT _ $1,000,000 A Professional Liability/ ZPL-14T239OA-13-17 11/1/2017 11/1/2016 Each Wrongful Act 1,000,000 Network & Information Security Aggregate 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) General Liability: Additional Insured and Waiver of Subrogation as required by written contract per Form CG D4 17 Products -Completed Operations coverage provided by Form CG D2 46 30 Day Notice of Cancellation as required by written contract per Form IL T8 03 Automobile Liability: See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins Purchasing THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins CO 80522 AUTH RIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC #: AnIIITInNAI RFMARK-q SrHFni ll F AGENCY NAMEDINSURED Arthur J. Gallagher Risk Management Services, Inc. SKC Communication Products, LLC POLICY NUMBER 8320 Hedge Lane Terrace Shawnee Mission, KS 66227 CARRIER I NAIC CODE EFFECTIVE DATE: DDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Additional Insured and Waiver of Subrogation as required by written contract per form CA T3 53 Workers Compensation: Waiver of Subrogation as required by written contract per Forms WC 00 03 13, WC 99 03 76, WC 99 03 A WC 42 03 04 Paqe 1 of 1 The City of Fort Collins and Poudre Fire Authority are included as additional insureds with respect to General Liability as required by written contract. ACORD 101 (2008/01) (9 2008 AUL)RU GUKNUKH I IUN. Hu rignts reservea The ACORD name and logo are registered marks of ACORD