HomeMy WebLinkAbout364100 L N CURTIS & SONS INC - INSURANCE CERTIFICATEA�� ® DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 0810912018
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 CONTACT
MARSH RISK & INSURANCE SERVICES NAME:
345 CALIFORNIA STREET, SUITE 1300 PJAIN.HgExt)_—_ — me Noll:
CALIFORNIA LICENSE NO.0437153 E-MAIL
SAN FRANCISCO, CA 94104 ADDRESS:
Attn: sanfrancisco.certs@marsh.com; Fax: 212-948-0398 INSURERS AFFORDING COVERAGE NAIC #
CN1 01 797553-STND-GAWU-1 8-19 INSURER A: Federal Insurance Company 20281
INSURED INSURER B : Great Northern Insurance Company 20303
L. N. Curtis & Sons, Inc.
Attn. John Viboch, CFO INSURER C :
1800 Peralta Street
INSURER D
Oakland, CA 94607-1603
INSURER E :
rnvlconr±cc 1`FI7TICICATF KH IMRFR• SFA-003569466-01 PFVI-RIO14 NI IMRFR- 1
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
SUBR
POLICY NUMBER
MM DDNYYY
EXP
MM DD Y YY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE Fx] OCCUR
$0 DEDUCTIBLE (SIR)
36023726
04/01/2018
04/01/2019
EACH OCCURRENCE
$ 1,000,000
DAMA E T ENTED
PREMISES Ea occurrence
$ 1,000,000
X
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER
X POLICY JE� LOC
OTHER
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 2,OOQ000
PER PROJECT AGG
$ 5,000,000
B
AUTOMOBILE LIABILITY
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
X HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
73583643
04/01/2018
04/01/2019
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
_
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
-----
$
COMP/COLL DEDS:
$ 1,000
UMBRELLA LIAR
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
DED RETENTION $
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
71737666
9/01/2019
X PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Re: Request for Proposal No. 8757; sale of ballistic vests and rifle plates.
The City, its officers, agents and employees are included as additional insureds (except workers' compensation) where required by written contract.
CFRTIFICATF HOLDER CANCELLATION
City of Fort Collins
P.O. Box 580
Fort Collins, CO 80522-0580
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
of Marsh Risk & Insurance Services
Kirsten Thomson _N �__ ice— --
U 1988-2016 ACORD CORPORA I ION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD