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HomeMy WebLinkAboutCOLORADO STATE UNIVERSITY - INSURANCE CERTIFICATE (3)AFRO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 08/03/2018 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 south, Inc. Franklin TN Office CONTACT NAME: A PHONE Ext): (866) 283-7122 FAX No ): (800) 363-0105 E-MAIL ADDRESS: 501 Corporate Centre Drive Suite 300 Franklin TN 37067 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: The Travelers Indemnity Co of CT 25682 Colorado State Universitv INSURER B: Lloyd's Syndicate No. 2987 AA1128987 1251 Mason Street Fort Collins Co 80523-6021 USA INSURERC: Safety National Casualty Corp 15105 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570072576490 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 INSR LTR TYPE OF INSURANCEADDL INSD SUER WVD POLICY NUMBER MMIDD/YYYY MW D/YYYY LIMITS B X COMMERCIAL GENERAL LIABILITY PK1 1 1 1 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X❑ OCCUR SIR applies per policy terns & condi ions AMA RENTED PREMISES Ea occurrence included MED EXP (Any one person) PERSONAL &ADV INJURY Included GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $1,000,000 X POLICY ❑ PRO ❑ LOC JECT PRODUCTS - COMP/OPAGG Included OTHER: A AUTOMOBILE LIABILITY BA-OH557779-18-CAG 08/01/2018 08/01/2019 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY ( Per person) ANYAUTO BODILY INJURY (Per accident) OWNED X SCHEDULED AUTOS ONLY AUTOS X HIREDAUTOS X NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGE Per accident B UMBRELLA LAB X OCCUR PK1033618 08/01/2018 08/01/2019 EACH OCCURRENCE $10,000,000 X EXCESS LIAB CLAIMS -MADE SIR applies per policy terns & condi lons AGGREGATE $10,000,000 DED I X RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY .� / N ANY PROPRIETOR I PARTNER I EXECUTIVE PERTOERTH- STAUTE E.L. EACH ACCIDENT OFFICERIMEMBER EXCLUDED? ❑ N / A E.L. DISEASE -EA EMPLOYEE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE-POLICYLIMIT C Excess WC SP4057454 08/01/2018 08/O112019 EL Each Accident $1,000,000 SIR applies per policy terns & condi ions EL Disease - Policy $1:000,000 EL Disease - Ea Emp $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is included as Additional Insured in accordance with the policy provisions of the General Liability and Auto Liability policies if required by written contract or agreement subject to the policy terms and conditions. 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 Attn: Purchasing - Gerry S Paul PO Box 580 Fort Collins Co 80522 USA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD