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HomeMy WebLinkAbout457775 FARNWORTH GROUP INC - INSURANCE CERTIFICATE�PS_>>trIN12.YIN1! 1 4D DATE (MMIDDIYYYY) ,4cokv CERTIFICATE OF LIABILITY INSURANCE 06/12/2017 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 1-800-527-9049 CONTACT NAME: Linda Bomarit0 /Audrey McNeill Holmes Murphy and Associates PHONE FAX IAI4 NO, E,O: 309-683-1065 _ Nol: 888-898-6604 - Peoria E-MAIL 311 S.W. Water Street ADDRESS: AMcNeilleholmesmurphy.com Suite 211 INSURER($) AFFORDING COVERAGE NAIL 0 Peoria, IL 61602-4108 INSURER A: XL SPECIALTY INS CO 37885 INSURED INSURER B : Farnsworth Group, Inc. INSURER C 2709 McGraw Drive INSURER INSURER E : Bloomington, IL 61704 1 INSURER F: 1-.,Ar0e r`CDTICIr`ATC MIIURCD- qnn RAIR1 RFVI31nN NIIIUI 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. L ADDL SUBR _ - POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE INSD I WVO POLICY NUMBER MMIDD MMIDDIYYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE E __ JCLAIMS -MADE I_ _ I OCCUR PREM SES tEa occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY i GENERAL AGGREGATE $ _ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ POLICY L__ _ J J OT ] LOC i OTHER: I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) i ANY AUTO BODILY INJURY (Per accident) f _ _ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident _ _ S UMBRELLA LIAR OCCUR EACH OCCURRENCE f _ AGGREGATE $ EXCESS LIAR -MADE _ _CLAIMS DIED RETENTION $ i WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NH) N 1 A I PER H STATUTE ER E.L. EACH ACCIDENT E E.L. DISEASE - EA EMPLOYE 9 E.L. DISEASE - POLICY LIMIT E It yes, describe under DESCRIPTION OF OPERATIONS below A !Professional Liability DPR9914827 06/15/17 06/15/18 lEach Claim 5,000,000 (Claims Made) Aggregate 10,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) FTC There is a 30 day notice of cancellation. Farnsworth Group, Inc. Project Manager Eric Culver L:tKIIFIGAIt MUL UItK 1.r+rnt ca v�Ilvr� SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. P.O. BOX 580 AUTHORIZED REPRESENTATIVE 215 N. Mason Fort Collins, CO 80524 USA © 1988-2014 ACORD CORPORA IUN. All rights reservea. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD lbomaritoil 50084381 r 0, O z W