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HomeMy WebLinkAboutCCMSI HOLDINGS INC - INSURANCE CERTIFICATECCMSHOL-01 MPRAXMARER ACORO CERTIFICATE OF LIABILITY INSURANCE P 7ATD/YYYY) /27/227/2017 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 Mesirow Insurance Services, Inc. 353 N. Clark St 11 th fl Chicago, IL 60654 CONTACT NAME: PHONE 312 595-6200 FAX arc No Ext : ( ) ruc No : IL E-MAADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Charter Oak Fire Insurance Company 25615 INSURED INSURER B : Federal Insurance Company 20281 CCMSI Holdings, Inc 2 East Main Street, Suite 208 Towne Centre Building INSURER C: INSURER D : INSURER E : Danville, IL 61832 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. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM DDY/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS -MADE Fx_] OCCUR 6301918P719COF16 11/17/2016 11/17/2017 PREMISES Ea occurrence S 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY 7PRO- JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER AUTOMOBILE LIABILITY COEaMBINED ccidentSINGLE LIMIT a $ 1,000,000 X BODILY INJURY (Per person) $ A ANY AUTO P8101918P719COF16 11/17/2016 11/17/2017 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) S X NON -OWNED HIRED AUTOS AUTOS X PROPERTY DAMAGE Per accident $ X Driver Other Car $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAB DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N I A PER OTH- STATUTE I I ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1 $ B Errors & Omissions 82257026 07/31/2017 07/31/2018 $150K SIR - $5M/AGG 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is named as additional insured under the automobile liability and general liability for work performed by the insured, only as required by written contract. I.tK I It - IL A I C r1ULUtK L AINI.tLLA I IUIV City of Fort Collins P.O. Box 580 Fort Collins, CO 80522-0000 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 p:C © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD