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HomeMy WebLinkAbout309950 T2 SYSTEMS INC - INSURANCE CERTIFICATE (10)DATE (MM!DD/YYYY) A�R,i7® CERTIFICATE OF LIABILITY INSURANCE 11/03/2016 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 CONTACT Willis of Michigan, Inc. NAME:__ _ _- c/o 26 Century Blvd PHONE FAX (AICNo Ext):1-877-945-7378 (A/C,No):1-888-467-2376 i P.O. Box 305191 E-MAIL Nashville, TN 372305191 USA ADDRESS: certificates@willis.com _ ( INSURER(S) AFFORDING COVERAGE NAIC # INSUREDT2 Systems, Inc. 8900 Keystone Crossing Suite 700 Indianapolis, IN 46240 INSURER B 40045 32603 INSURERD AXIS Insurance Company _ I 37273 COVERAGES CERTIFICATE NUMBER:WI696231 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 DAMAGES RENTED CLAIMS -MADE -X. J OCCUR PREMISES Ea occurrence ( $ 1, 000, 000 MED EXP (Any one person) $ 10, 0" A ` i Y TCP 7007311 10/31/2016 10/31/2017 -------------- PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY a PRO- �] LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO A ALL OWNED SCHEDULED AUTOS AUTOS y TCP 7007311 10/31/2016 10/31/2017 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED -HIRED AUTOS AUTOS I $ B X UMBRELLA LIAR it OCCUR X EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10,000,000 EXCESS LIAB CLAIMS -MADE TUL 7007372 10/31/2016 10/31/2017 I DED RETENTION $ $ C WORKERS COMPENSATION AND .EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE PER OTH- X STATUTE ER — E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N /A TWC 7007313 10/31/2016 10/31/2017- E.L. DISEASE - EA EMPLOYEE (Mandatory in NH) $ 1,000,000 If yes, describe under lo DESCRIPTION OF OPERATIONS bew E.L. DISEASE - POLICY LIMIT $ 1,000,000 (_ D i!Cyber Security Liability ECN000249581601 10/31/2016 10/31/2017 Limit: $10,000,000 Retroactive Date: 1/l/2004 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) he City of Fort Collins, CO is added as an Additional Insured as respects the General Liability and Liability per attached forms. f 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. City of Fort Collins AUTHORIZED REPRESENTATIVE 215 North Mason P.O. Box 580 Fort Collins, CO 80522 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD25 (2014/01) The ACORD name and logo are registered marks of ACORD SR ID:13617962 BATCH:Batch #: 264370