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HomeMy WebLinkAboutPLAYPOWER HOLDINGS INC - INSURANCE CERTIFICATE (4),4�Ro CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 08/28/2017 I 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 AOn Risk Services Central, Inc. St. Louis MO office CONTACT NAME: (AJC..NN . Ext): (866) 283-7122 FAX No.): (800) 363-0105 E-MAIL ADDRESS: 8182 Maryland Avenue St Louis Mo 63105 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Everest National Insurance Co 10120 Plavpower Holdings, Inc. INSURERB: Liberty insurance Corporation 42404 11515 vanstory Drive suite 100 INSURER C; Pennsylvania Manufacturers' Assoc Ins Co 12262 HUNTERSVILLE NC 28078 - 6417 USA INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570068142889 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. Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDNYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y CF GL EACH OCCURRENCE $1,000,000 CLAIMS -MADE X❑ OCCUR SIR applies per policy terns & condi ions AMA PREMISES Ea occurrence $300,000 MED EXP (Any one person) PERSONAL & ADV INJURY $1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY M PRO JECT � LOC PRODUCTS - COMP/OP AGG $4 , 000 , 000 OTHER: SIR $ 500 , 000 C AUTOMOBILE LIABILITY Y 151600-06-52-32-1 09/01/201610/01/2017 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY ( Per person) BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUTOS X NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGE Per accident xiANYAUTO $1.000 Ded. Comp X $1,000 Ded. Collisior B X UMBRELLA LIAB X OCCUR TH7691464580016 09/01/20161010112017 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS -MADE Umbrella AGGREGATE $5,000,000 DED I X RETENTION S 10, 000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR / PARTNER /EXECUTIVE 2017750652321 09/01/2017 10/01/2017 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) ❑ N I A E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below 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) Playpower LT -Farmington, Inc., formerly know as Little Tikes Commercial Play Systems. RE: The supply of playground equipment. The City of Fort Collins and Colorado (Avery Park) are included as Additional Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. m C d P lY 2 0 2 rn Do 0o R 0 r uo CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. �[ The City Of Fort Collins AUTHORIZED REPRESENTATIVE Purchasing Department RE PO Box 580 Fort Collins Co 80522 USA l� ��L� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000052633 LOC #: A ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Services Central, Inc. NAMED INSURED Playpower Holdings, Inc. POLICY NUMBER see Certificate Number: 570068142889 CARRIER See Certificate Number: 570068142889 NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Named Insured schedule PlayPower Inc. (First named insured) Additional Named Insureds Play Holdings Inc. PlayPower Holdings, Inc. PlayPower Finance, Inc. Miracle Recreation Equipment Company Miracle Midwest E-7 Dock, Inc. Kid Play, Inc. Soft Play, L.L.C. sprectra Turf, Inc. PlayPower LT Farmington, Inc. PlayPower LT Canada Inc. Play Design International SARL Playworld Systems, Inc. (Effecitve 1/1/17) Hags Play Europe AB and its Subsidiary companies, Hags Play AB, Hags Denmark; and Hags-MB-Spelidee GMBH; Hags swelik SA PlayPower UK Limited and its subsidiary SMP (Playgrounds) Limited E-Z Dock Europe SA But only while the first named insured directly or indirectly owns, during the policy period, an interest therein of more than 50%. The ACORD name and logo are registered marks of ACORD