HomeMy WebLinkAbout516354 THE OMEGA GROUP INC - INSURANCE CERTIFICATE (2)Ago CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
12/15/2016
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 CONTACT
Marsh Risk & Insurance Services NAME___
PHONE _----_-_-._-..--------- FAX
1735 Technology Drive, Suite 790 A/c No):
San Jose, CA 95110 E-MAIL
wnncccc.
J20763-STND-GAWUE-16-17 INSURER A: Federal Insurance Company
INSURED Trimble Inc. INSURER B : Travelers Property Casualty Co. Of America
The Omega Group INSURER C : Lloyd's Of London
5160 Carroll Canyon Road, Suite 100 INSURER D : Great Northern Insurance Company
San Diego, CA 92121
rr1VFRAPFC rFRTIFIr-ATF NI IMRFR• SEA-002727390-09 RFVISIAN NI IMRFR-5
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
POLICY EFF
MMIDD/`/YYY
POLICY EXP
MM/DD/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE Lxl OCCUR
35323540
12/01/2016
12/01/2017
EACH OCCURRENCE
$ 1,000,000
A AGE TED
PREM SESOEa occurrence)
$ 1,000,000
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER.
PRO -
POLICY ❑PRO ❑ LOC
OTHER
GENERAL AGGREGATE
$ 2,000,000
X
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
D
AUTOMOBILE LIABILITY
X ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
HIRED AUTOS X AUTOS
F
73257020
1210111116
12/01/2017
COMBINED SINGLE LIMIT
(Ea accident
$ 1,000,000
BODILY INJURY (Per person)
_
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
_
COMP/COLL
$ 1,000
A
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
79724719
12/01/2016
12/01/2017
EACH OCCURRENCE
$ 2,000,000
AGGREGATE
$ 2,000,OW
DED RETENTION $
$
B
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE �
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
HC2JUB-8363M832-16(Ded)
HRKUB-117D3437-16 Retro
( )
Deductible: $250,000
12101/2016
12101/2016
12/01/2017
12/01/2017
X PER oTH-
STATUTE ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
C
Electronic
Errors & Omissions
N101C7161101
12/01/2016
12/01/2017
Limit 2,000,000
Deductible 500,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Evidence of Insurance
rFRTIFIrATF H(11 r1FR CANCFI I ATION
City of Fort Collins
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Attn: Ed Bonnette, Purchasing
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
PO Box 580
ACCORDANCE WITH THE POLICY PROVISIONS.
Fort Collins, CO 80522
AUTHORIZED REPRESENTATIVE
of Marsh Risk & Insurance Services
Petronella Massey��—
U 19115-ZU14 A(;QKL) GQKF(JKA I IQN. All rlgnts reserve(!.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD