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HomeMy WebLinkAbout563449 CENTERLINE SOLUTIONS LLC - INSURANCE CERTIFICATE (7)AGURD,M CERTIFICATE OF LIABILITY INSURANCE DATEIMM/DD/YYYY) 2/1/2019 1 /24/2018 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 polil 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 Lockton Companies CONTACT 8110 E. Union Avenue Suite 700 Denver CO 80237 PHONEFAX A/C No Ext : A/C No E-MAIL ADDRESS: INSURER AFFORDING COVERAGE NAIC a (303) 414-6000 INSURER A; Zurich American Insurance Company 16535 INSURED Centerline Solutions, LLC 1408175 16035 Table Mountain Parkway Golden, CO 80403 INSURER B : Endurance American Insurance Company 10641 INSURER C : Berkley Assurance Company 39462 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 14355937 REVISION NUMBER: XXXXXXX 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 TYPE OF INSURANCE ADDL INSD SUER WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP (MM/DD1YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY Y N GLA023211902 2/L/2018 2/l/2019 EACH OCCURRENCE 1,000,000 CLAIMS -MADE � OCCUR PREM SES (E. oceurr0ence)1,000,000 X MED EXP (Any oneperson) 10,000 Contractual Llab X XCU PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECT LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER. A AUTOMOBILE LIABILITY Y N GLA023211902 2/l/2018 2/l/2019 COMBINED SINGLE LIMIT Ea accident $ 2,000 000 X BODILY INJURY (Per person) $ XXXXXXX ANY AUTO OWNED AUTOS ONLY AUTOS BODILY BODILY INJURY (Per accident $ XXXXXXX HIRED AUTOS ONLY AUTOS ONE (per .c,ca ,DAMAGE $ XXXXXXX $XXXXXXX B X UMBRELLA LAB X OCCUR N N EXC30000049902 2/1/2018 2/1/2019 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 EXCESS LIAB CLAIMS -MADE DIED I I RETENTION $ $ XXXXXXX A WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY y/N N WCO23211702 2/1/2018 2/l/2019 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 1 000 000 OFFICER/MEMBERAN /EXCLUDED4 ECUTIVE NN (Mandatory in NH) If yes describe under DESCRIPTION OF OPERATIONS below N / A E.L. DISEASE - EA EMPLOYEE 1,000,000 E.L. DISEASE - POLICY LIMIT I S 1,000,000 A Inst Floater; Leased/Rented Equip N N CPP023212502 2/1 /2018 2/l/2019 $1 M. $250Khtem C Prof/Poll/Cyb PCADB50014410218 2/1/2018 2/1/2019 $5M/clm prf, $5M/clm pal, $12M agg, Cyber $2M DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Fhe City of Fort Collins is included as additional insured with respect to General and Auto Liability as required by written contract. ti�l�i7llall�li\� 7i1V1IR 9 q I L95-11 h: Pl4i al orL\ LL919 14355937 The City of Fort Collins Purchasing, Department PO 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 Lbali , 9`1,tli4r ©1 8 20015 ACORD CORPO ATION- All Hants reserved ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD