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HomeMy WebLinkAbout618638 EVERLAST CLIMBING INDUSTRIES INC - INSURANCE CERTIFICATE (3)i , ® ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 07/31/2018 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 Marsh USA, Inc. Two Alliance Center CONTACT NAME: PHONE FAX A/c No _ E-MAIL ADDRESS: 3560 Lenox Road, Suite 2400 Atlanta, GA 30326 Attn: Atlanta.CertRequest@marsh.com ! Fax: 212-948-4321 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Westchester Fire Insurance Company 10030 CN102326389-Eved-GAUWX-18-19 INSURED Everlast Climbing, Inc. 42 Northern Stacks Drive INSURER B : Phoenix Insurance Company 25623 INSURER C : National Union Fire Insurance Co. of Pittsburgh, PA 19445 INSURER D : Travelers Property Casualty Company Of America 25674 Suite 100 Minneapolis, MN 55421 INSURER E : Liberty Surplus Insurance Corp10725 INSURER F : CnVFRAnFS CF_RTIFICATF NUMBER: ATL-004838641-04 REVISION NUMBER: 2 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 LTRINSD TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MMIDDM'YY POLICY EFF EXP MMI C 'YYY LIMITS A X COMMERCIAL GENERAL LIABILITY G2821800A002 08/01/2018 08/01/2019 EACH OCCURRENCE $ 2,000,000 FV7 CLAIMS -MADE OCCUR DAMAGE TO RENTE PREMISES Ea occur ence $ 100,000 X SIR $50,000 Per Occ. MED EXP (Any one person) $ EXCLUDED PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OP AGG $ 4,000,000 POLICY PRO- LOC POLICY AGGREGATE $ 10,000,000 OTHER: D AUTOMOBILE LIABILITY TJ-CAP-9D897065TIL-18 08/01/2018 08/01/2019 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTYDAMAGE Per accident $ Comp/Coll Ded: $1,000 $ X UMBRELLA LIAB X OCCUR BE 014788208 08/01/2018 08/01/2019 EACH OCCURRENCE $ 25,000,000 AGGREGATE $ 25,000,000 EXCESS LIAB CLAIMS -MADE DIED I X I RETENTION $10 000 $ D B D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N OFFIC RPMEMBEREXC U ED?ECUTIVE N (Mandatory in NH) NIA TROUB-9D90032-6-18 TC2NUB 9D90031 4-18 UB-7J602089-18-14-G 08l0112018 08/01/2018 08I01/2019 08/011201ANYPRO9 08/01/2019 X PER OTH- STATUTE ER E.L.EACHACCIDENT $ 1,000,000 E.L.DISEASE -EA EMPLOYEE $ 1,000,000 E.L DISEASE -POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below ( 9e.) See Additional Pa E Excess Umbrella 1000054456-08 08/01/2018 08/01/2019 Each Occurrence 25,000,000 Aggregate 25,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Quotation # QTE-00043730-5 - Supply of Bike Rails and Racks - FC Bike/Transportation Planning City of Fort Collins, its officers, officials, agents, and employees are listed as additional insured as their interests may appear during and until completion of the supply of materials, on a primary and non-contributory basis, on the General Liability via CG 2010 and Automobile Liability via CA T4 37 policies, when required by written contract. A Waiver of Subrogation applies in favor of the additional insureds on the Workers Compensation policy, when required by written contract. CERTIFICATE HOLDER CANCELLATION City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO Box 580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Fort Collins, CO 80522 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi MukherjeeQur © 1988-2016 ACORD CORPORA I ION. All rlgnts reservea. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD