ICMA-RC VANTAGECARE 1A - Laserfiche WebLink

Home Browse Search

/ -' i V �1 - t.1 it ./_A t f� os'o 0 AC40RO CERTIFICATE OF LIABILITY INSURANCE DATE (MWDD/YYYY) 071310012 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 MARSH USA INC. SUITE 400 1255 23RD STREET, N.W. WASHINGTON, DC 20037 CONTACT NAME: PHONE FAX AAIC. No. ExII)e I (A/C, No): E-MAIDR L ADESS: INSURER (S) AFFORDING COVERAGE NAIC R INSURER A: St. Paul Protective Insurance Company 19224 040356-- EO +FI -12 -13 INSURED ICMA RETIREMENT CORP. ATTN: BARBARA STOTLER INSURER B: Federal Insurance Company 20281 INSURER C: St. Paul Fire & Marine Ins Co 24767 INSURER 0: Standard Fire Insurance Company 19070 777 NORTH CAPITOL ST., N.E. WASHINGTON, DC 20002 INSURER E: Great American Insurance Co. 16691 INSURER F: GE T AGGREGATE LIMIT APPLIES PER: X i POLICY F1 PRO- LOC PRODUCTS - COMP /OP AGG COVERAGES CERTIFICATE NUMBER: CLE- 003743124 -08 REVISION NUMBER:5 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 POLICY EFF MM/DD/VYYY POLICY EXP MMIDD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fq OCCUR X CONTRACTUAL COV. INCL. of Marsh USA Inc. ZLP10S82630 08/01/2012 08/01/2013 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE T AGGREGATE LIMIT APPLIES PER: X i POLICY F1 PRO- LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ AUTOMOBILE LiA6iLITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS pp Ay i rO A, �: 4 (1' 3()� -,, �a o �y COMBINED SINGLE LIMIT Ea accident! BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ rD UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE A$Slbta12L EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER /MEMBER EXCLUDED? F`N] (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA UB- 6508M89-4 -12 08/01/2012 08/01/2013 X WCSTATU- 0TH- E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 $ B C BANKERS PROF. LIAB. BANKERS PROF. LIAB. 8211 -6261 14RN20360 04119/2012 04/1912012 04/19/2013 04/19/2013 LIMIT 17,500,000 SIR 1,000,000 DESCRIPTION OF OPERATIONS! LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION CITY OF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN: EXECUTIVE DIRECTOR OF PERSONNEL SVS THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 CIVIC CENTER PLAZA M -34 ACCORDANCE WITH THE POLICY PROVISIONS. SANTA ANA, CA 92702 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee ®1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD