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HomeMy WebLinkAbout524235 MONARCH MEDIA INC - INSURANCE CERTIFICATE (4)CERTIFICATE OF LIABILITY INSURANCE [DATE (MXDDIYYYY) 2/31/2016 THIS CERTIFICATEIS 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 PAYCHEX INSURANCE AGENCY INC/PAC 250881 P: F: (888) 443-6112 PO BOX 33015 SAN ANTONIO TX 78265 CONTACT NAME (a° o,Exq: wcN-): (888) 443-6112 EAWL ADDRESS INSURERS) AFFORDING COVERAGE NAIC* INSURER A: Multiple Companies INSURED MONARCH MEDIA, INC. T 406 MISSION ST STE U SANTA CRUZ CA 95060 INSURER B INSURER C INSURER O . INSURERE INSURER F: rnVFRArFs CFRTIFICATE NUMBER: 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. luvlq? 71PEOFINSUR4NCE ADDL SUBB POLICTNUMBER POL11-1 D YTFY TOLIGTF_iT LAITIS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS -MADE ❑ PREMISESS(OCCUR DAMAGERENTED (Ea occurrence) —_ MED EXP (Any one person) PERSONAL & ADV INJURY GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE g PRODUCTS-COMPIOP AGG g POLICY PRO- LOC JECT OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY (Ea accident) _ BODILY INJURY (Per person) n ANY AUTO f OWNED SCHEDULED BODILY INJURY (Per accident) i AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE (Per accident) g UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS -MADE AGGREGATE - DE RETENTION S i wORKEASCOMPEN.SADON ANDEMPLDI'ERS'7IABWn ANY PROPRIETORIPARTNER/EXECUTIVEY/N X PER OTH- STATUTE ER E.L. EACH ACCIDENT 11,000,000 A OFFICERIMEMBER EXCLUDED? (Mandatory in NH) ❑ NIA 76 KEG PH3984 01/30/2017 01/30/2018 E.L. DISEASE -EA EMPLOYEE "] y 000 y 000 E.L. DISEASE - POLICY LIMIT "1 y 0 0 0 y 0 0 0 If yes, describe under DESCRIPTION OF OPERATIONS below [T] DESCRIPTION OF OPERA17ONSILOCATIONS/ VEHIC(AUORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations_ Certificate Holder is an Additional Insured per the Business Liability Coverage Form SS0008 attached to this policy. r`roTlrl!`ATr unl nGa CANCFLLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE City of Fort Collins, Colorado DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AU774ORIzmREPRESENTA77VE Attn: : David Carey 1 PO BOX 580 FORT COLLINS, CO 80522 OO 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD