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HomeMy WebLinkAbout105832 LISTENUP INC - INSURANCE CERTIFICATE (5)DATE (MM/DD-)
� CERTIFICATE OF LIABILITY INSURANCE
O1/03/2017
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 endorsement(s).
PRODUCER Willis of Colorado, Inc. CONTACT
NAME:
c/o 26 Century Blvd PHONE FAX
!AIC1-877-945-7378 1-888-467-2378
P.O. Box 305191 No. Exth AIC Nol:
E-MAIL certificates@xillis.com
Nashville. TN 372305191 USA ADDRESS:
INSURED ListenOp Inc.
5295 E Evans Avenue
Denver, CO 80222
INSURE S AFFORDING COVERAGE NAIC#
INSURERA: Trawlers Property casualty company of America 25674
INSURERS: Travelers Casualty and Surety Company 19038
INSURER C: Plnnacol Assurance Company 41190
- -I INSURER E :
COVERAGES CERTIFICATE NUMBER: W1890910 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
SUER
POLICY NUMBER
POLICY EFF
MM/DDlYYYY
POLICY EXP
MM/DD YY
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
CLAIMS-MADE FKOCCUR
DAMAGE TO RENTE-D-
PREMISES Ea occurrence
$ 300,000
MED EXP (Any one person)
$ 5,000
A
Y
680-7427R464-16-42
09/30/2016
09/30/2017
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
PRO❑LOC
JECT
X
2,000,000POLICY
$
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
BODILY INJURY (Per person)
$
X ANY AUTO
H
OWNED SCHEDULED
AUTOS ONLY AUTOS,
Y
BA-709OH533-16-SEL
09/30/2016
09/30/2017
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
'',
$
A
j(
UMBRELLA LIAS
X
OCCUR
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
I $ 5,000,000
EXCESS LAS
CLAIMS -MADE
CUP-1862Y452-16-42
09/30/2016
09/30/2017
DIED I X I RETENTION $ 5, 000
Is
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED? No
(Mandatory in NH)
N/A
4065550
01/01/2017
01/01/2018
X PER OTH-
STATUTE ER
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
_ _
$ 1,000,000
i
DESCRIPTION OF OPERATIONS ! LOCATIONS! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
City of Fort Collins is included as an Additional Insured as respects to General Liability and Auto Liability.
ULK I It-IUA I It MULUtK LANI tLLA I IUN
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
ty of Fort Collins
Box 580
O 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
SR ID: 13883204 RATCB: Batch fi: 275299