HomeMy WebLinkAboutLAMAR ADVERTISING COMPANY & ALL SUBSIDIARIES - INSURANCE CERTIFICATE (3)10
ACCORD CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDIYYYY)
12/13/2016
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 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
Marsh USA Inc.
701 Poydras Street, Suite 4125
NewOrleans.CertRequest@marsh.com
New Orleans, LA 70139
CONTACT
_NAME: _...._
PHONE FAX
_ tuC No :
E-MAIL
ADDRESS:
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A: Insurance Company of the State of Pennsylvania
19429
INSURED Lamar Advertising Company
& all subsidiaries
INSURER B : New Hampshire Insurance Company
23841
--
INSURER C: National Union Fire Insurance Co. of Pittsburgh, PA
19445
INSURER D :
Post Office Box 66338
Baton Rouge, LA 70896
INSURER E
INSURER F :
rnVP0Ar_9c rFRTIFIreTF NIIMRFP- HOU-002816942-02 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
ICY EFF
MOE 0/YYYY
POLICY EXP
MM DD/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE 1XJ OCCUR
GL2039105 (AOS)
01/01/2017
01/01/2018
EACH OCCURRENCE
$ 2,000,000
PREM SO ESEa oNcu ante
$ 1,000,000
MED EXP (Any one person)
$ 100,000
PERSONAL & ADV INJURY
$ 2,000,000
GENE AGGREGATE LIMIT APPLIES PER:
X POLICY PRO ❑ LOC
JECT
OTHER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
A
A
AUTOMOBILE LIABILITY
X ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
X X NON -OWNED
HIRED AUTOS AUTOS
X PIP FL & MI
CA9734201 (AOS)
CA9734202 (MA)
01/01/2017
01/01/2017
01/01/2018
01/01/2018
COMBINED SINGLE LIMIT
Ea accident ___
$ 2,000,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTYDAMAGE
r a
---
$
$
C
X
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
19452256
01101/2017
01/01/2018
EACH OCCURRENCE
$ 1,000,000
N
AGGREGATE
$ 1.000,000
DED I I RETENTION $
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY IN
ANY PROPRIETOR/PARTNER/EXECUTIVE Y�
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
WC068022338(AOS)
01/01/2017
01/01/2018
X STA LITEOERH
EL EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
See Additional Information
for Other WC Policies
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Certificate holder is/are included as Additional Insured under General Liability and Auto Liability as required by written contract.
rCOTICIrATC LJnI 11711170 rAPJrFI 1 ATION
City of Fort Collins & Transfort
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
PO Box 580
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Fort Collins, CO 80522
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
of Marsh USA Inc.
Robert C. Hill
U 1988-2014 AGOKD GOKPUKA I IUN. All rlgnts reservea.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: Lamar
LOC #: New Orleans
.vc VKu AUUI I IUNAL KtnnAKt%Z0 ZourycuuL�
AGENCY NAMEDINSURED
Marsh USA Inc. Lamar Advertising Company
& all subsidiaries
POLICY NUMBER Post Office Box 66338
Baton Rouge, LA 70896
CARRIER NAIC CODE
EFFECTIVE DATE:
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance
Other Policies:
Workers Compensation Policies:
WC068022339 (IL, KY, INC, UT) New Hampshire Insurance Company Eff: 01-01-2017 Exp: 01-01-2018
WC068022340 (NJ, PA) New Hampshire Insurance Company Eff: 01-01-2017 Exp: 01-01-2018
WC068022341 (AZ, VA) New Hampshire Insurance Company Eff: 01-01-2017 Exp: 01-01-2018
WC068022337 (CA) National Union Fire Insurance Company Eff: 01-01-2017 Exp: 01-01-2018
WC068022335 (FL) Illinois National Insurance Company Eff: 01-01-2017 Exp: 01-01-2018
WC068022343 (ME) New Hampshire Insurance Company Eff: 01-01-2017 Exp: 01-01-2018
WC068022342 (MA, WI, ND, OH, WA, WY) New Hampshire Insurance Company Eff: 01-01-2017 Exp: 01-01-2018
4CORD 101 (2008/01) to Luva A%-UrtU %'U1%r1%jMM I rUrv. r+n I Iwovi.c.
The ACORD name and logo are registered marks of ACORD