HomeMy WebLinkAbout162378 ONERAIN INC - INSURANCE CERTIFICATE (6)CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
�12/5/2016_
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 endorsements .
PRODUCER
PAYCHEX INSURANCE AGENCY INC
2-y1�0754 P: F: (888) 443-6112
PO BOX 33015
SAN ANTONIO TX 78265
CONTACT
NAME:
(NC,No.Ext).
(aC.No): (888) 443-6112
ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC#
INSURERA: Multiple Companies
INSURED
ONERAIN INC.
1531 SKYWAY DR UNIT D
LONGMONT CO 80504
INSURER IS:
INSURER C :
INSURER D:
INSURER E:
INSURER F:
9"AVCMA/2C¢ r`FRTIFICATF NIIMRFR• KICVINIUN NUMKr-K:
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.
LVV2
7TPE0FBV9URA1VCE
ADDL
SUBR
POLICYNUMBER
POD
POMC,YEXP
yAMIS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
5
CLAIMS -MADE ❑OCCUR
DAMAGES(RENTED
PREMISES (Ea occurrence)
S
MED EXP (Any one person)
g
PERSONAL BADVINJURY
$
GEN'L AGGREGATE LIMIT APPLIES PER.,
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
POLICY PRO LOC
JECT
S
OTHER
COMBINED SINGLE LIMIT
AUTOMOBILE LIABILRY
(Ea accident)
BODILY INJURY (Per person)
ANY AUTO
OWNED SCHEDULED
BODILY INJURY (Per accident)
$
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
(Per accident)
$
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
d
CLAIMS -MADE
AGGREGATE
$
DE
RETENTION $
$
WORKEW COLIPEA'S HOT!'
AND EMPLOYERYLL41BLUTY
ANY PROPRIETORIPARTNEREXECUTIVEY/N
XPER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$1 r 0 0 0 r 0 0 0
A
OFFICERMEMBER EXCLUDED?
(Mandatory in NH) ❑
WA
76 WEG EV9735
12/31/2016
12/31/2017
E.L. DISEASE -EA EMPLOYEE
~1r 000, 000
If yes, describe under
E.L. DISEASE - POLICY LIMIT
$1 r 0 0 0 I, 0 0 0
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS ILOCA77ONS / VEHIC(MORD 101, Additional Remarks Schedule, may be attached if more space is required)
Those usual to the Insured's Operations.
C1:RTI1ArATF FI(N nF=R GANGtLLA I JUN
The City of Fort Collins
Purchasing Department
PO BOX 580
FORT COLLINS, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE
DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
RD CORPORATION. All rights resery
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD