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HomeMy WebLinkAboutTHE CPI GROUP - INSURANCE CERTIFICATEClient#: 1084199 CPIGRO1 DATE (MM/DD/YYYY) ACORD,. CERTIFICATE OF LIABILITY INSURANCE 1/16/2018 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER ICONTACT NAME: USI Colorado, LLC Prof Liab PHONE FAX P.O. Box 7050 /C Lo Et): 800 873-8500 vc No Englewood, CO 80155 ADDRESS: _ 8OO 873-8500 _ INSURER(S) AFFORDING COVERAGE NAIC #_ INSURER A: Landmark American Insurance Company 33138 INSURED The CPI Group 7400 E Orchard Rd., Suite 270 Greenwood Village, CO 80111 INSURER B • RSUI Indemnity Company INSURER C • Pin—[ Assurance Company INSURER D : Houston Casualty Company INSURER E : Hartford Underwriters Insurance Co. COVERAGES CERTIFICATE NUMBER: REVISION NL]MRFR: 1190 30104 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 CONTRACTOR 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 ADDLSUBR INSR WVD POLICY NUMBER POLICY EFF POLICY EXP MM/DD MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE D OCCUR X X LHA111479 1/12/2018 01/12/2019 EACH OCCURRENCE $1 000 000 PREMISES EaEocccu ante $50OOO X MED EXP (Any one person) $O BI/PD Ded:5,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY � ECT LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 $ OTHER: E AUTOMOBILE LIABILITY X X 34UEGIQ1105 1/12/2018' 01/12/201 COMBINED SINGLE LIMfT Ea accident 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS tid P BODILY INJURY (Per accident) ) $ X HIRES ONLY X NON -OWNED AUTOS ONLY PROPERTY DAMAGE Par accident _ $ $ B UMBRELLA LIAB X OCCUR NHA081872 1/12/2018 01/12/2019 EACH OCCURRENCE s6,000,000 x AGGREGATE s6,000,000 EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ X PER OTH- $ 2/01/2018 02/01/201 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBEREXCLUDED? N/A x 4170679 E.L. EACH ACCIDENT - $1 000 0O0 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 D Professional HCC1865826 01/12/2018I01/1212019 $1,000,000 per claim Liability $2,000,000 annl aggr. Claims Made DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) As required by written contract or written agreement, the following provisions apply subject to the policy terms, conditions, limitations and exclusions: The Certificate Holder and owner are included as Automatic Additional Insured's for ongoing and completed operations under General Liability and Designated Insured under Automobile Liability but only with respect to liability arising out of the Named Insured's work performed on behalf of the certificate holder and owner. The General Liability, Automobile Liability, (See Attached Descriptions) The City of Ft. Collins Attn: Delynn Coldiron P.O. Box 580 Fort Collins, CO 80522-0580 L9l_1Ply 414 W_11I Lai .I 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 ACORD 25 (2016/03) 1 of 2 #S22343819/M22342891 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SLMZP DESCRIPTIONS (Continued from Page 1) insurance applies on a primary and non contributory basis. A Blanket Waiver of Subrogation applies for General Liability, Automobile Liability and Workers Compensation. The Umbrella / Excess Liability policy provides excess coverage over the General Liability, Automobile Liability and Employers Liability. Please note that Additional Insured status does not apply to Professional Liability or Workers' Compensation. License #13-255 SAGITTA 25.3 (2016/03) 2 of 2 #S22343819/M22342891