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HomeMy WebLinkAbout582778 CORVEL ENTERPRISE COMPANY - INSURANCE CERTIFICATE (7)Ago CERTIFICATE OF LIABILITY INSURANCE FDATE /YYYY) o412s/2017120n 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. NAME: 540 W. MADISON PWC,HONE FAX No): CHICAGO, IL 60661 E-MAIL Attn: chicago.CertRequest@marsh com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Travelers Property Casualty Company of America 256 INSURED INSURER B : N/A N/A CorVel Enterprise Comp, Inc. Attn: Jay Villeda INSURER C : Illinois Union Insurance Company 279 2010 Main Street, Suite 600 INSURER D : Irvine, CA 92614 — - - - INSURER E : COVERAGES CFRTIFICATF NI IMRFR• r:Hl-O(IfiQ7fi5nR_m DMIM1n411 ul uaDCD.7 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 SUBR WVD POLICY NUMBER POLICY EFF MM/DDNYYY POLICY EXP MM/DD/YYYY - LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR TJGLSA280K5095-17 04/3012017 04/30/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREM SES (Ea occurrence) $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRO- X POLICY D JECT LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMPIOP AGG $ 2,000,000 $ OTHER A AUTOMOBILE LIABILITY TJCAP280K5102-17 04/30/2017 04/30/2018 COMBINED SINGLE LIMIT Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident ( ) $ NON -OWNED HIRED AUTOS X AUTOS X PROPERTY DAMAGE Per accident $ Comp./Coll. Ded. $ 500 UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB DED RETENTION $ $ A A WORKERS COMPENSATION YIN AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? a N / A TC2JUB280K5071-17 (ADS) TRKU6280K5083-17 (AZ, MA, NE, WI) 04/30/2017 04/30/2017 04/30/2018 04/30/2018 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 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 C Managed Healthcare Prof. Liab. MSP G27108647 004 (SIR: $300,000) 10/31/2016 10/31/2017 Per Claim 5,000,000 Retro date: 04-10-1987 Aggregate 5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) The City of Fort Collins its officers, agents and employees are included as Additional Insured under the General Liability and Auto Liability policies as their interest may appear, but only to the extent such status is required under their written contract I agreement with the Named Insured, VCR 111171%.,M I C r7VLUCrx 1L ANI:tLLA I IVN City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Ann: Gerry Paul THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 215 North Mason ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. ManashiMukherjee �ta.�.wvs.: �rlL,ctc_eec. © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD