Supporting Documentation · Nov 25, 2024
315-24 Attachment.pdf
c9471b3ee2388cd22f24dea606c27b627faee2173fee1ee0ef818a1273b1c7dcIndexed text · page 59
Show all pagesDATE (MNIDDIYYYY) XJ ACORD CERTIFICATE OF LIABILITY INSURANCE —,,.,,, | “@seune THIS CERTIFICATE (S 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 cerlificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certaln 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 Lockton Companies, LLC Smee” 444 W. 47th Street, Suite 900 PHONE [FE wo Kansas City MO 64112-1906 Cua AE. Nek (816) 960-9000 ADDRESS: kcasu@lockton.com INSURER(S} AFFORDING COVERAGE _Naic # wsurer A: Nautilus nce Company 17370 1a46962, MATRIX NEW WORLD ENGINEERING, LAND SURVEYING | #surens: Great Divide Insurance Company 25224 AND LANDSCAPE ARCHITECTURE, PC wsuren c : Allmerica Financial Alliance Ins Co 10212 26 COLUMBIA TURNPIKE insurer 0: Houston Casualty Company 42374 FLORHAM PARK NI 017932 —e- INSURER F COVERAGES CERTIFICATE NUMBER: 20860343 REVISION NUMBER: XXXXXXX THIS 1S 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. Nee | TYPE OF INSURANCE eaieal POLICY NUMBER (GRIDDED | MOON | ums. | A |X Veuneaaoe [x] Senin N | N} EcP201734119 32/2024 3/2/2025 [eacuoccurnence _| |s 2,000,000 CLANS-MADE |_X | OocUR PREMISES (Ea occurronce) | $ 300,000 |X_|_ Pollution Liab | MED EXP tAny one person) | $ 5,000 X_| Contractual Liab | PERSONAL & ADV INJURY. |} |GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE | roucy [x] 88% [ ]u0e FeRODUGTS.- COMPIOP AGE X | omen: Poll Per Claim: $2M | CC | AUTOMOBILE LABILITY N
tractual Liab | PERSONAL & ADV INJURY. |} |GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE | roucy [x] 88% [ ]u0e FeRODUGTS.- COMPIOP AGE X | omen: Poll Per Claim: $2M | CC | AUTOMOBILE LABILITY N NJ AWYJ42223301 3/2/2024 | 3/2/2025 ENGEL TMF ir 1,000,000_ X | anv auto [Boo wuuR @erperon) | XXXXKXK |_| aurosomy |_| AGfog “=? | [BoDny mae 1S XXXXXXX [X | aUTosomy |X| Aros ONLY | [eePoceueny ACE 8 XXXXXXX | { |s XXXXXXX A |_| UMBRELLA LIAB fora N | N) FFX201734219 37272024 | 3/2/2025 | EACH OCCURRENCE $ 10,000,000 X | Excess ae CLAINS-MADE [AGGREGATE |s 10,000,000 pep |__| RetenTions | [s XXXXXXX. B END CMPLOveRG: CISILITY ull N| wea2017344 sano | 202s | X [Starve | [ERT | jORPARTNERIEXECUTIVE Et, EACH ACCIDENT $ 1,000,000 ANY PROPRIETS GFFICERMEMBER EXCLUDED? (Mandatory in NH) , describe under | | | tes DISEASE- EA EMPLOYEE! § 1,000,000 | DESCRIPTION OF OPERATIONS below | EL_ DISEASE - POLICY LIMIT |$ 1.000.000 A | PROFESSIONAL | N | N) BCP201734119 3/2/2024 | 32/2025 LIMIT PER CLAIM: $2M D | CYBER | | H23NGP22309701 3/2/2024 | 3/2/2025 | LIMIT OCC/AGG: $5M DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES _ 101, Additional Remarks Schedule, may be aitached if more apace is required) RE: EVIDENCE OF INSURANCE, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE GANCELLED BEFORE 20860343 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN SAMPLE CERTIFICATE HOLDER ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED an (| yesh © 19882015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The AGORD name and logo are registered marks of ACORD
File revisions (1)
- Sep 29, 2026
c9471b3ee2387,412,771 bytes