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HomeMy WebLinkAboutI-KOTA INC - INSURANCE CERTIFICATE (6)i3.101 .M111 DENESEB �acoRL� CERTIFICATE OF LIABILITY INSURANCE FDATE(MMIDWYYYY) 03/8/2017 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 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 CCIG 5660 Greenwood Plaza Blvd. Suite 500 Greenwood Village, CO 80111 CONTACT Virginia Shaw AMA__ A/CNNo, EXt): (720) 330-7903 PHOE A//c, No :(303) 799-0156 E-MAIL ADDRESS, GinnyS@thinkccig.com r INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Westfield Insurance 24112 INSURED INSURER B : Plnnacol Assurance 41190 INSURER C : The Hanover Insurance Co. 22292 I -Kota Inc Attn: Riley McLaughlin 90 Galapago St INSURER D : INSURER E : Denver, CO 80223 INSURER F : COVERAGES CERTIFICATE NUMBER: 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. INSR T TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF YY POLICY EXP LIMITS /YY A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE n OCCUR X CMM0982161 03/10/2017 03/101201$ I EACH OCCURRENCE DAMAGE To RENTED PR MI oc yLrr= ME EXP (Any oneperson) 1,000,000 $ 500,000 $ $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY"POLICYFx7 JECT F7x LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY X�ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY AUTOS ONEY CMM0982161 j 03/10/2017 03/10/2018 SINGLE LIMIT COMBINED aaccident) $ 1,000,000 BODILY INJURY Perperson) $ BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident $ A X UMBRELLA LAB EXCESS LIAB X OCCUR CLAIMS -MADE CMM0982161 03/10/2017 03/10/2018 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ DED I X RETENTION $ 01 Aggregate $ 5,000,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N rzirANY PR OPR.IJISE /PARTNER/EXECUTIVE OFFICctor in NH) EXCLUDED^ I_J ( andatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 14138$98 04/01/2017 j � 04101/2018 X P7ER TE OTH- ER E.L_EA_C_HAC_CID_ENT E.L. DISEASE - EA EMPLOYEE $_ 1,000 000 110001000 $ E.L. DISEASE - POLICY LIMIT 1,000,000 $ C Leased/Rented Equip IH4969369304 06/25/2016 06/25/2017 Limit -ACV 250,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) As required by written contract or written agreement, City of Fort Collins is included as Additional Insured under General Liability. City of Fort Collins 300 LaPorte Avenue Fort Collins, CO 80521 Iu1� SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH 1'HE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD