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HomeMy WebLinkAbout582944 RALPH ANDERSEN & ASSOCIATES - INSURANCE CERTIFICATERECEIVE- L; ® ,4 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 10/16/2017 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 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 (916) 387-6800 (888) 250-8403 Ice Insurance Agency PO Box 340338 �" '- CONTACT NAME: Ice Insurance Agency_ IA Et): .Ext): (916) 387-6800 a/c No: 888 250-8403 A MAIL info@iceins.com INSURERS AFFORDING COVERAGE NAIC# Sacramento, CA 95834 �j ,�i•1 t)�I l) I sr [ j/ INSURER A: Philadelphia Indemnity Insurance Comp 18058 INSURED 'I#{ Ralph Andersen & AssociatesManager's Office INSURER B: Hartford Accident & IndemnityCompany 22357 INSURERC: INSURER0: 5800 Stanford Ranch Rd., #400 INSURERE: Rocklin, CA 95765 INSURER F : Rr1V9=RA(19=R rtFRTIFICATF NIIMRFR- 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 ADDL SUBR POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDDIYYYY LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR PHSD1283292 11/10/2017 11/10/2018 EACH OCCURRENCE $ 1 OOO 000 DAMAGE _T0 RENTED PREMISES (Ea occurrence) $ 10O 000 -_ MED EXP (Any one person) $ 5 000 PERSONAL BADVINJURY $ 1 000 000 GENERAL AGGREGATE s3.000.000 _ GEN 11 AGGREGATE LIMIT APPLIES PER: POLICY II PRO LOC PRODUCTS - COMP/OP AGG s3,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO AALL UTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PHSD1283292 PHSD1283292 11/10/2017 11/10/2018 COMIEe aBcldeDISINGLE LIMIT 1M0,000 _ BODILY INJURY (Per person) $ $ $ BODILY INJURY (Per accident) PROPERTY DAMAGE Per accident $ A ✓ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE PHUB603393 11/10/2017 11/10/2018 EACH OCCURRENCE $ 1 ,000,000 AGGREGATE $ 1,000,000 DL� ' RETENTION $ 10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I " ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? Y❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 57WECP19708 10/20/2017 10/20/2018 / W C STATU- OTH- v I - E.L. EACH ACCIDENT $ 1 000 000 E.L. DISEASE - EA EMPLOYEE $ 1 000 000 E.L. DISEASE - POLICY LIMIT $ 1 A Errors and Omissions PHSD1283292 11/10/2017 $2,000,000 Per Occurance 11/10/2018 $2,000,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Fort Collins, its officers, agents and employees listed as additional insured CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 AUTHORIZED RYFPRE T ?I E Fort Collins, CO 80522 Attn: Kelly DiMartino © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD noms any+ !o-o are registered marks of ACORD