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HomeMy WebLinkAbout235414 JUDGE NETTING - INSURANCE CERTIFICATE (5)CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 12/26/2017 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 Robert Harris Insurance Agency, Inc. Lic. #0216736 3150 Bristol St., Suite 200 Costa Mesa CA 92626 CONTACT Adriana Lopez NAME: P PpHi�NfVo Ext (714) 619-4480 FAX No: (714)619-4481 E-MAIL adriana@reharris.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURERA:West American Insurance Company 44393 INSURED Judge Netting, Inc. 427 E. 17th St. Costa Mesa, CA 92627 INSURERB:American Fire & Casualty Company 24066 INSURER C :BHHC INSURERD:Continental Divine Insurance INSURERE: INSURER F : Cr)VFPAnFA CFRTIFICATF NUMRFRI8/19 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. NOTVNTHSTANDING 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. 1NSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER EFF MMIDD/YYYY POLICY E XP MM/DD/YPOLICY YYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE X� OCCUR DAMAGE(Ea RENTED PREMISESSoccurrence $ 100,000 MED EXP (Any one person) $ 15,000 BKW58275737 1/1/2018 1/1/2019 PERSONAL & ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JE� LOC PRODUCTS - COMP/OPAGG $ 2,000,000 Employee Benefits $ 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea ccident a $ 1,000,000 BODILY INJURY (Per person) $ B X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BAA58275737 1/1/2018 1/1/2019 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED X HIRED AUTOS X AUTOS Medical Expense $ 5,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 5,000,000 B EXCESS LIAB CLAIMS -MADE DEDT I RETENTION$ $ ESA58275737 1/1/2018 1/1/2019 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE JUWC908357 1/1/2018 1/1/2019 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 D OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N / A JUWC908497 1/1/2018 1/1/2019 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins, its officers, agents and employees are named as additional insured when required by written contract per the attached CG8810 04/13, CG2037 07/04, Auto AI CA8810 01/13 CERTIFICATE HOLDER UANc:tLLA I IUN City of Fort Collins 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 M Lauren Atkinson/ALO ~--- © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)