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HomeMy WebLinkAboutVOYA FINANCIAL INC - INSURANCE CERTIFICATE (12)A� 1 " CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 05/26/2017 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 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 'MARSH USA, INC. TWO ALLIANCE CENTER 3560 LENOX ROAD, SUITE 2400 ATLANTA, GA 30326 CONTACT NAME: PHONE IFAX (A/C, No): _I E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC Jt INSURER A: New Hampshire Insurance Company 23841 JO I 525-Voya-AMER-1 8-17 INSURED Voya Financial, Inc. 230 Palk Avenue INSURER B: National Union Fire Insurance Co. of Pittsburgh, PA 19445 INSURER C : N/A N/A INSURER D : American Home Assurance Co 19380 New York, NY 10169 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: ATL-003938861-05 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. INSRPOLICY LTR TYPE OF INSURANCE INSD WVD SUER POLICY NUMBER EFF MM/DD/YYYY POLICY EXP MMIDD/YYYY LIMITS B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR Contractual Liab. Coverage GL1929920 05/30/2017 05/30/2018 EACH OCCURRENCE $ 2,000,000 A Al TO TED rccu ence)$ PREM SES (E. occurrence) 250,000 X MED EXP (Any one person) $ 5,000 X Host Liquor is included PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X PRO - POLICY1:1 PRO ❑ JECTLOC OTHER: GENERAL AGGREGATE $ 5,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B B AUTOMOBILE LIABILITY X ANY AUTO X ALL OWNED SCHEDULED X AUTOS AUTOS X NON OWNED HIRED AUTOS AUTOS CA2820250 (AOS) CA2820251 (MA) 05/30/2017 05/30/2017 05/30/2018 05/30/2018 COMBINED SINGLE LIMIT Ea accident $ 2,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPER ci IDAMAGE $ COMP/COLL $1,000 DED $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE BE28199184 05/30/2017 05/30/2018 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DIED I X I RETENTION $ lO 000 $ A B D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WC055816120 (ADS) AZ, VA WC055816123 ( ) WC055816121 CA ( ) 'WC Continued on Attached' 05/30/2017 05/30/2017 05/30/2017 05/30/2018 05/30/2018 05/30/2018 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE -POLICY UNIT $ 1,000,000 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 additional insured on the above general liability policy and auto liability policy, where required by written contract but only with respect to liability arising out of the operations of the named insured. RFaTIGIr`ATF unl nFR CANCELLATION City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 215 N. Mason St. FI 2 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Fort Collins, CO 80524-4402 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Ronald A. Santaniello /�r/►�cAAiJ © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ACORD® AGENCY CUSTOMER ID: J01525 LOC #: Atlanta AnnlTIMIAll RI=MARI[C QrL4Pn111 1: AGENCY NAMED INSURED 'MARSH USA, INC. Voya Financial, Inc. 230 Park Avenue POLICY NUMBER New York, NY 10169 CARRIER I NAIC CODE EFFECTIVE DATE: ITHIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Workers Compensation Continued. Policy No. WC055816124 (IL, KY,NC,NH,UT) Carrier: New Hampshire Insurance Company Effective Date: 05/30/2017 - 05/30/2018 Policy No. WC055816125 (NJ, PA) Carrier: New Hampshire Insurance Company Effective Date: 05/30/2017 - 05/30/2018 Policy No. WC055816122 (FL) Carrier Illinois National Insurance Company Effective Date: 05/30/2017 - 05/30/2018 Policy No. WC055816126 (MA, ND, OH, WA, WI,WY) Carrier: New Hampshire Insurance Company Effective Date: 05/30/2017 - 05/30/2018 pans 7 of 7 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD