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HomeMy WebLinkAboutVOYA FINANCIAL INC - INSURANCE CERTIFICATE (14),41C'oRn® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 11/0812016 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 USA, INC. PHONE FAX TWO ALLIANCE CENTER 1C,N1-- 3560 LENOX ROAD, SUITE 2400 E-MAIL ATLANTA, GA 30326 ADDRESS: INSURERS AFFORDING COVERAGE _ NAIC # J01525-Voya-AMER-16-17 INSURER A: New Hampshire Insurance Company 23841 INSURED Voya Financial, Inc. INSURER B : National Union Fire Insurance Co. of Pittsburgh, PA 19445 230 Park Avenue INSURER C : Granite State Insurance Cc 23809 New York, NY 10169 INSURER D : CnVFRAil CFRTIFICATF NIIMRFIR ATL-004044106-02 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. INSR LTR OF INSURANCE ADDLTYPE INSD WVDSUBIR POLICY NUMBER MM POLICY EFF IDD/YYYY POLICY EXP MM/DD/YYY Y LIMITS B X COMMERCIAL GENERAL LIABILITY X GL1721754 05/30/2016 05/30/2017 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE � OCCUR PREMISES DAMAGE TO RENTED Ea occurrence $ 250,000 X MED EXP (Any one person) $ 5,000 Contractual Liab. Coverage X Host Liquor is included PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 5,000,000 POLICY PRO ❑ LOC X JECT PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER A AUTOMOBILE LIABILITY X CA3940556 (AOS) 05/30/2016 05/30/2017 COMBINED SINGLE LIMIT Ea accident $ 2,000,000 BODILY INJURY (Per person) _ $ C X ANY AUTO CA3940557 (MA) 05/30/2016 05/30/2017 BODILY INJURY (Per accident) $ X ALL OWNED SCHEDULED AUTOS AUTOS PROPERTY DAMAGE Per accident $ NON -OWNED AUTOS X HIRED AUTOS rLX COMP/COLL $1,000 DED $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB IH CLAIMS -MADE DED RETENTION $ $ A A B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YNN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A WCO20765106 (AOS) WCO20765109 (AZ) WCO2O765107 CA ( ) 05130/2016 05I30/2016 05I30/2016 05/30/2017 05/30/2017 05/30/2017 X STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L DISEASE - POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below "WC Continued on Attached` DESCRIPTION OF OPERATIONS I 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 and auto liability policies, where required by written contract but only with respect to liability arising out of the operations of the named insured. l.tF( 1 Ir11,A I C r1ULL/t11 %,KIVliCLLA I Iv17 City of Fort Collins 215 N. Mason St., 2nd Floor P.O. 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. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Ronald A. Santaniello -ott�J/,r © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD ,acoR" AGENCY 'MARSH USA, INC. POLICY NUMBER CARRIER AGENCY CUSTOMER ID: J01525 LOC #: Atlanta ADDITIONAL REMARKS SCHEDULE NAIC CODE NAMED INSURED Voya Financial, Inc. 230 Park Avenue New York, NY 10169 EFFECTIVE DATE: ADDITIONAL KtMAKKJ THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Workers Compensation Continued Policy No. WCO20765110 (IL, KY,NC,NH,UT) Carrier: New Hampshire Insurance Company Effective Date: 05130/2016 - 05/30/2017 Policy No. WCO20765111 (NJ, PA) Carrier: New Hampshire Insurance Company Effective Date: 05/30/2016 - 05130/2017 Policy No. WCO20765108 (FL) Carrier: Illinois National Insurance Company Effective Date: 05/30/2016 - 05/30/2017 Policy No. WCO20765112 (MA, ND, OH, WA, WI,WY) Carrier: New Hampshire Insurance Company Effective Date. 05/30/2016 - 05/30/2017 Page 2 of 2 IlA [] A TIA\I All w .. 6*- roc er••orl ACORD101 (2008/01) �.,....�,.......,.....-•--••--••_._.......� The ACORD name and logo are registered marks of ACORD