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PARKEON INC - INSURANCE CERTIFICATE (8)
DATE(MM/DDIYYYY) A�Rp CERTIFICATE OF LIABILITY INSURANCE 01 /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 CONTACT Aon Risk Services Northeast, Inc. NAME: New York NY Office (AJC.NNo. Ext): PHE (866) 283-7122 lac. No.): (800) 363-0105 199 Water Street E-MAIL New York NY 10038-3551 USA ADDRESS: INSURED INSURER A: Parkeon. Inc. INSURER B: 40 Twosome Dr. Unit 7 Moorestown NJ 08057 USA INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570065132936 INSURER(S) AFFORDING COVERAGE NAIC # The Travelers Indemnity Co of CT 25682 ACE American insurance Company 122667 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 N LTR TYPE OF INSURANCE I INSD U WVD POLICY NUMBER P LI Y MM/DD/YYYY LI Y XP MM/DD/YYYY LIMITS B X COMMERCIAL GENERAL LIABILITY OGLG 4 EACH OCCURRENCE $1, 000, 000 CLAIMS -MADE X❑OCCUR DAMAGE RENTED PREMISES Ea occurrence $1,000,000 MED EXP (Any one person) $10, 000 PERSONAL B ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $1,000,000 X POLICY ❑ PRO ❑ JECT LOC PRODUCTS - COMP/OP AGG $1,000,000 OTHER: A AUTOMOBILE LIABILITY BA-1F74188A-16 11/17/2016 11/17/2017 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY ( Per person) X ANY AUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HI RED AUTOS NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGE Per accident .1 Comp $1000 X Coll $1000 B X UMBRELLA LIAB OCCUR XOOG24997194 01/01/2017 01/01/2018 EACH OCCURRENCE $6,000,000 EXCESS LIAB H CLAIMS -MADE AGGREGATE $6,000,000 DED I X RETENTION 810, 000 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR / PARTNER, EXECUTIVE N UB1F74188A16 11/17/2016 11/17/2017 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) ❑ N / A E.L. DISEASE -EA EMPLOYEE $1,000,000 If ves. desr-ribe under DESCRIPTION OF OPERATIONS below - FOLICY LIMIT I $i cc0 c00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Evidence of coverage 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 215 N Mason St. Fort Collins c0 80524 USA d c m B d ' 0 x to cn rn CNI 0 0 r` �n ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD