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HomeMy WebLinkAboutGOODWILL INDUSTRIES OF DENVER - INSURANCE CERTIFICATE (9)ACORCI® CERTIFICATE OF LIABILITY INSURANCE ATE D09/06/2017Dlyvyv) 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 MARSH USA INC. 122517TH STREET, SUITE 1300 CONTACT NAME: A ONE A/C No ADDRESS: -- — DENVER, CO 80202-5534 Attn: DENVER CERTREQUEST@MARSH.COM FAX: (212) 948-4381 INSURER S AFFORDING COVERAGE NAIC # INSURER A: Philadelphia Indemnity Insurance Company 18058 402175-STND-GAWU-17-18 INSURED GOODWILL INDUSTRIES OF DENVER INSURER B : Plnnacol Assurance 41190 — ----- INSURER C : 6850 NORTH FEDERAL BOULEVARD DENVER, CO 80221 INSURER D INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: SEA-003351184-16 REVISION NUMBER: 8 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 MM/DD YYYY MM/DD YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE AI OCCUR X PHPK1705252 09/01/2017 09/01/2018 EACH OCCURRENCE $ 1,000,000 _ DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 20,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY ❑ PRO ❑ JECT LOC OTHER. GENERAL AGGREGATE $ 3,000,000 X PRODUCTS - COMP/OP AGG $ 3,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY X PHPK1705252 09/01/2017 09/01/2018 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accdent $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED F1 RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? [N] (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A 4133992 09/01/2018 X PER orH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,g00 LE I I I I I I I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: CONTRACT TERM: 9-1-15 THROUGH 8-31-16 CERTIFICATE HOLDER IS ADDITIONAL INSURED AS RESPECTS TO AUTO LIABILITY AND GENERAL LIABILITY WHERE REQUIRED BY WRITTEN CONTRACT FOR GOODWILL'S NEGLIGENCE ONLY. l"a;IN 112LrL'\Ia 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 of Marsh USA Inc. Kathleen M. Parsloe� @ 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD [iRo® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 09/06/2017 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 CONTACT MARSH USA INC. NAME: — PHONE FAX 122517TH STREET, SUITE 1300 A/C, No. ExL (A/C, No): DENVER, CO 80202-5534 ADDRESS Attn: DENVER.CERTREOUEST@MARSH.COM FAX: (212) 948-4381 - 402175-STND-GAWU-17-18 INSURED GOODWILL INDUSTRIES OF DENVER 6850 NORTH FEDERAL BOULEVARD DENVER, CO 80221 INSURER A: F ritla(lelpnla Indent INSURER B : Plnnacol Assurance INSURER D : INSURER E : COVFRAGFS CFRTIFICATF NIIMRFR- SEA-003351131-04 RFVISIC)N NIIMRFR• 1 NAIC # 18058 41190 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 INSD SWVD UER POLICY NUMBER MM DPOLIDNYYY MMIDD YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X I OCCUR PHPK1705252 09/01/2017 09/01/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RE NTE PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 20,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. POLICY ❑PRO JECT ❑ LOC OTHER. GENERAL AGGREGATE $ 3,000,000 X PRODUCTS - COMP/OP AGG $ 3,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PHPK1705252 09,101/2017 09/01/2018 MBINED SINGLE LIMIT COEacident ac $ 1,000,000 X BODILY INJURY (Per person) _ $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE PHUB598776 09/01/2017 09/01/2018 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED I X I RETENTION $ 1O O00 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4133992 09/01/2018 X PER OTH- STATUTE JER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE — $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is additional insured as respects to auto liability and general liability, where required by written contract. The following Contract Term shall be: 9-1-16 through 8-31-17, CERTIFICATE HOLDER CANCELLATION City of Fort Collins PO Box 580 Ft. 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 of Marsh USA Inc. Kathleen M. Parsloe ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) A�RD CERTIFICATE OF LIABILITY INSURANCE F09/04/2017 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 CONTACT MARSH USA INC. _NAME:_ PHONE FAX 122517TH STREET, SUITE 1300 xD DENVER, CO 80202-5534 E-MAIL Attn: DENVER. CERTREQUEST@MARSH.COM FAX: (212) 948-4381 ADDRESS _ INSURERS) AFFORDING COVERAGE NAIC # 402175-STND-GAWU-17-18 INSURED GOODWILL INDUSTRIES OF DENVER 6850 NORTH FEDERAL BOULEVARD DENVER, CO 80221 c: E: Pinnacol Assurance �w�owi+oc� !`1=0r1l=l1 ArC 4u111aGCO• SF4-0034n9d00_01 RFVIRIn?J MIIMRFR• 2 18058 41190 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTVVITHSTANDING 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. OF INSURANCE ADDLSUBRTYPE Juja WVD POLICY NUMBER MM DID/YYYY MM DD/YYYY LIMITS rA X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR PHPK1705252 09/01/2017 09/01/2018 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence) $ 1,000,000 MED EXP (Any one person) $ 20,000 PERSONAL & ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER. X POLICY PRO LOC JECT OTHER. GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OP AGG $ 3,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED rxX ONLY AUTOS ONLY PHPK1705252 09/01/2017 09/01/2018 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTYDAMAGEAUTOS Pera ccidentt UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DIED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE YIN EXCLUDED? ❑N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4133992 09/01/2018 X H STATUTE ER — E.LEACH ACCIDENT $ 1,000,000OFFICER/MEMBER E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is named as additional insured as respects general liability policy where required by written contract. CERTIFICATE HULUER t A1Yl,CLLFt I IVIY 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 of Marsh USA Inc. Kathleen M. Parsloe ..,1{sX". hr. 4441.s-- U 1ytftf-LUIb AL UKU 1,UKYUKA 1 IVIv. All rights reserveu. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD A�coR,D CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 09/05/2017 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 MARSH USA INC. 1225 17TH STREET, SUITE 1300 DENVER, CO 80202-5534 Attn: DENVER.CERTREQUEST@MARSH.COM FAX: (212) 948-4381 CONTACT NAME: PHONE T FAX IAIC. No.xt (A/C No): _. E-MAIL ADDRESS: _ _ _ INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Philadelphia Indemnity Insurance Company 18058 402175-STND-GAWU-17-18 _ INSURED GOODWILL INDUSTRIES OF DENVER INSURER B : Plnnacol Assurance 41190 — 6850 NORTH FEDERAL BOULEVARD INSURER C : _ INSURER D DENVER, CO 80221 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: SEA-003502443-01 REVISION NUMBER: 3 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMIDD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR PHPK1705252 09/0112017 09/01/2018 EACH OCCURRENCE $ 1,000,000 TED PREMISES (Ea occurrence) $ 1,000,000 MED EXP (Any one person) $ 20,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. POLICY ❑ PRO ❑ LOC JECT OTHER: GENERAL AGGREGATE $ 3,000,000 X PRODUCTS - COMP/OP AGG $ 3,000,000 A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY rX PHPK1705252 09/01/2017 09/01/2018 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 _ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident) $ UMBRELLA LIAR EXCESS LIAB OCCUR EACH OCCURRENCE $ $ _ HCLAIMS-MADE AGGREGATE _ DIED $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4133992 09/01/2018 X OTH- STATUTE ER STA E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 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 included as additional insured (except workers' compensation) where required by written contract. CERTIFICATE HOLDER LAIN rLL.AIIvey 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 of Marsh USA Inc. Kathleen M. Parsloe rn . i44,az.-- V 11dWS-LUTb At..UKU %,UKYUKAI IUIV. Ali ngnTS reserves. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD