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HomeMy WebLinkAbout106536 MILLIMAN INC - INSURANCE CERTIFICATE (7)A� o CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNYYY) I 07,09I2018 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 Aon Risk Services Northeast, Inc. New York NY Office CONTACT NAME: AICNNo. Ext): (312) 381-1000 AIC.No.: (312) 381-7007 E-MAIL ADDRESS: 199 water Street NeW York NY 10038-3551 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURERA: National Fire Ins. Co. of Hartford 20478 Milliman, Inc. INSURER B: Valley Forge Insurance CO 20508 Fifth Avenue Ste. 3800 Ste. INSURERC: The Continental Insurance Company 35289 INSURER D: American Casualty Co. of Reading PA 20427 Seattle WA 98101 USA INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570072231090 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. Limits shown are as requested INSR LTR TYPE OF INSURANCE UDI. NSD SUOKI WVD POLICY NUMBER MMIDDIYYYY EFF POLIO EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS -MADE X❑ OCCUR General Liability DAMAGE O PREMISES Ea occurcence $1,000,000 MED EXP (Any one person) $15 , 000 PERSONAL& ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000, 000 POLICY ❑ PRO � LOC JECT PRODUCTS - COMP/OP AGG $2,000, 000 OTHER: B AUTOMOBILE LIABILITY C 6071827272 Auto Liability 06/30/2018 06/30/2019 COMBINED SINGLE LIMIT Ea accident $1,000,000 ANYAUTO BODILY INJURY ( Per person) BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGE Per accident .1 Deductible - $1 000 C X UMBRELLA LIAB X OCCUR 6071837378 06/30/2018 06/30/2019 EACH OCCURRENCE $5,000,000 EXCESS LIAR CLAIMS -MADE Umbrella Liability AGGREGATE $5,000,000 DED RETENTION C A D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A wC 6 71865486 wC 6 71866153 wC 6 71865178 workers Compensation 06/30/2018 06/30/2018 06/30/2018 06/30/2019 06/30/2019ER 06/30/2019 X I STATUTE OTH- 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, 0o0 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may he attached if more space is required) The City of Fort Collins is Additional Insured on the General Liability and Automobile policies per the attached endorsements/forms. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins AUTHORIZED REPRESENTATIVE Attn: John Voss P.O. Box 580 Fort Collins CO 8OS22 USA (Y, i= ?�r� r�sNt�tedc// aarid�i �srra ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD m