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HomeMy WebLinkAbout235414 JUDGE NETTING INC - INSURANCE CERTIFICATE (9)ACOR" CERTIFICATE OF LIABILITY INSURANCE Ill DATE(MM/DD/YYYY) 12/19/2016 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 Chrystal Rott NAME: a/c No Ext: (714) 619-4480 me No: (714)619-4481 E-MAIL ADDRESS: Ch stal@reharris.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Golden Eagle Insurance Co INSURED Judge Netting, Inc. 427 E. 17th St. Costa Mesa CA 92627 INSURER B :Netherlands Insurance Company INSURERC:Berkshire Hathaway Homestate Ins Co INSURERD:Continental Divide Insurance Co. INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:17-18 Liability 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE �X OCCUR REMDAMAGE TO RENTED PISES Ea occurrence PREM $ 100,000 MED EXP (Any one person) $ 5,000 CBP8993288 1/1/2017 1/1/2018 PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 GEN'L POLICY ] JE � LOC PRODUCTS - COMP/OP AGG $ 2,000,000 Employee Benefits $ 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ B X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BA8994288 1/1/2017 1/1/2018 BODILY INJURY (Per accident) $ X NON -OWNED HIRED AUTOS X AUTOS PROPERTY DAMAGE Per accident $ Medical Expense $ 5,000 UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5 OOO 000 AGGREGATE $ 5,000,000 A X EXCESS LAB CLAIMS -MADE CU8994488 1/1/2017 1/1/2018 DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE JUWC805601 1/1/2017 1/1/2018 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000 000 D OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N I A JUWC805715 1/1/2017 1/1/2018 E.L. DISEASE - EA EMPLOYEE $ 1 000 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Contractors Equipment CBP8993288 1/1/2017 1/1/2018 Leased/Rented Equipment $800,000 Deductible $1, 0 0 0 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City, its officers, agents and employees are named as Additional Insureds as their interest(s) may appear regarding any and all work performed by the above named insured per attached GECG970 0111, CG 2037 0704 and GECA701 0107. CERTIFICATE HOLDER CANCELLATION City of Fort Collins 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 Lauren Hopper/ROTT -�'A ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) INS025 (201401) The ACORD name and logo are registered marks of ACORD