HomeMy WebLinkAbout120394 BECKER ARENA PRODUCTS INC - INSURANCE CERTIFICATE (4)ACORN® CERTIFICATE OF LIABILITY INSURANCE
DA 1z/27,20 1 17Y-Y)
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 Kelly Burnette
NAME:
MHS Insurance Agency LLC
A CONNo Ext : (952)544-5150 FAX No) (952)541-3619
10900 Wayzata Blvd
E-MAIL ADDRESS: kburnette@mhscos.com
INSURER(S) AFFORDING COVERAGE
NAIC #
Suite 130
Minnetonka MN 55305
INSURER A : Great American Insurance Companies
INSURED
INSURER B : Allmerica Financial Benefit
41840
INSURER C : Rated by Multiple Co's
00914
Becker Arena Products Inc., DBA: Rink Equipment Resource
INSURER D :
720 Innovation Drive
INSURER E :
INSURER F:
Shakopee MN 55379
COVERAGES CERTIFICATE NUMBER: 18-19 GL 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.
ILTR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
MM/DD/YYYY
MM/DD/YYYY
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE Fx� OCCUR
DAMAUIL IU HEN ILL)
PREMISES Ea occurrence
$ 100,000
MED EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,000
A
Y
PL4958261
01/01/2018
01/01/2019
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
X PRO-LOCPRODUCTS
POLICY F
$ 2,000,000
Employee Benefits
$ 1,000,000
OTHER:
AUTOMOBILE LIABILITY
COMBIN ED SINGLE LIMIT
Ea acciden,)
$ 1,000,000
BODILY INJURY (Per person)
$
X ANY AUTO
B
OWNED SCHEDULED
AUTOS ONLY AUTOS
Y
AVVXA187761
01/01/2018
01/01/2019
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
Underinsured motorist
$ 1,000,000
X
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 10,000,000
A
EXCESS LIAB
CLAIMS -MADE
XS4958262
01/01/2018
01/01/2019
AGGREGATE
$ 10,000,000
DIED RETENTION $
$
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MENIBEREXCLUDEC^
(Mandatory in NH)
N/A
41WEBX3247
01/01/2018
01/01/2019
X STATUTE EORH
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE -POLICY LIMIT
1,000,000
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Certificate holder is additional insured with respect to General Liability and Automobile.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
The City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 582
AUTHORIZED REPRESENTATIVE
Fort Collins CO 80522
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