HomeMy WebLinkAbout579299 HOSPITAL COURIERS DENVER LLC - INSURANCE CERTIFICATE (2)ACORO' CERTIFICATE OF LIABILITY INSURANCE
9/23/2018
DATE(MMIDDrYYY)
1 9/22/2017
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 Lockton Companies
444 W. 47th Street, Suite 900
Kansas City MO 64112-1906
(816) 960-9000
TCT
NAME:
PH N FAX
A/C No Ext : AIC, No):
E-MAIL
ADDRESS:
INSURER AFFORDING COVERAGE
NAIC #
INSURER A: The Phoenix Insurance Com anv
25623
INSURED HOSPITAL COURIERS DENVER, LLC
INSURER B : Travelers Indemnity Co of CT
25682
1421697 4520 FLORENCE STREET
DENVER, CO 80238
INSURER C : Navi ators Insurance Com anv
42307
D : AGCS Marine Insurance Company
22837
-INSURER
INSURER E : Liberty Insurance Underwriters Inc
19917
INSURER F : Travelers Property Casualty Co of America
25674
COVERAGES CERTIFICATE NUMBER: 14390981 REVISION NUMBER: XXXXXXX
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
INSD
SUBR
%WD
POLICY NUMBER
POLICY EFF
MMIDDn'YYY
POLICY EXP
MMlDD/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
Y
N
660- 3G984100-PHX-17
9/23/2017
9/23/2018
EACH OCCURRENCE
1,000,000
DAMAGE TO RENTED
PREMISES Ea occurrence
1,000,000
CLAIMS -MADE Fx_1 OCCUR
MED EXP (Any oneperson)10,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
]{ POLICYā¯‘ SECT LOC
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
OTHER:
B
AUTOMOBILE
LIABILITY
Y
N
840-3G984100-TCT-17
9/23/2017
9/23/2018
EO MBIINEDtSINGLE LIMIT
$ 1,000,000
X
BODILY INJURY (Per person)
$ XXXXXXX
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident
$ YYYY M
X
PROPERTY DAMAGE
Per accident
$ XXXXXXX
HIRED NON -OWNED
AUTOS ONLY X AUTOS ONLY
$XXXXXXX
C
X
UMBRELLA LIAB
X
OCCUR
N
N
CHI7UMR854635IV
9/23/2017
9/23/2018
EACH OCCURRENCE
$ 10 000,000
I
AGGREGATE
$ 10.000 000
EXCESS LIAB
1CLAIMS-MADE
DED I X I RETENTION $ 10,000
PROD/COMP. OPS
$ 10,000,000
F
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETORIPARTNEPJFXECUTIVE FN_1
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
N / A
N
UB-5J740165-TIL-17
9/23/2017
9/23/2018
X STATUTE ER
E.L. EACH ACCIDENT
$ 1,000 000
E.L. DISEASE - EA EMPLOYEE
1,000,000
If yes, describe uncler
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
S 1,000,000
D
MOTOR TRUCK CARGO
N
N
MZI93078913
9/23/2017
10/1/2018
LIMIT: $350,000
E
CRIME/EMPLOYEE
FI3CABJG79001
10/1/2017
10/1/2018
LIMIT: $3,000,000
THEFT
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
COVERAGE REFERENCED ABOVE IS EFFECTIVE 12/1/2016 UNTIL THE EXPIRATION DATE OF THE CERTIFICATE. THE CITY OF FORT
COLLINS, CO, ITS OFFICERS, AGENTS, AND EMPLOYEES ARE LISTED AS ADDITIONAL INSURED AS RESPECTS GENERAL LIABILITY
AND AUTOMOBILE LIABILITY AS REQUIRED BY WRITTEN CONTRACT SUBJECT TO POLICY TERMS AND CONDITIONS.
I.CK 1 II-K.A I C r1VLUCR
14390981
CITY OF FORT COLLINS, COLORADO
ATTN: DIRECTOR OF PURCHASING AND RISK MANAGEMENT
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
Arr)Pn 7S r7nlFrn,4i
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