|
A� O® CERTIFICATE OF LIABILITY INSURANCE
<br />ATEIMh1fODlYYYY)
<br />12104!2017
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />Z' REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />MARSH USA INC.
<br />122517TH STREET, SUITE 1300
<br />CONTACT
<br />NAME:
<br />Fa cNn o Ext : FAX No l:
<br />DENVER, CO 80202 -5534
<br />Attn: Denver.CertRequest @marsh.com; F: 212 - 948-4381
<br />VMAIL s:
<br />6603K662699
<br />12!0112017
<br />kilo,
<br />1270 18
<br />INSURERS AFFORDING COVERAGE
<br />NAIC #
<br />INSURER A: Chaster Oak Fire Insurance Company
<br />615
<br />CN119172492-- GAWFP -17 -18
<br />INSURED GI Peak Holding Corporation
<br />INSURER B: Travelers Propeoy Casuah Co. Of America
<br />LT5674
<br />INSURER C: Travelers Casualty Insurance Company Of Amen
<br />19046
<br />6400 S. Fiddlers Green Circle
<br />Greenwood Village, CO 80111
<br />INSURER D: Beazley Group.
<br />GENERAL AGGREGATE
<br />INSURER E now
<br />PRODUCTS - COMPIOP AGG
<br />-
<br />INSURER F:
<br />$
<br />A
<br />COVERAGES CERTIFICATE NUMBER: SEA - 003523679 -01 REWISION IIIMBER: 0
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED N7%LD .,OOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OT ❑OCU WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCR1 HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAI
<br />I�TR
<br />TYPE OF INSURANCE
<br />ADDL
<br />5LIBR
<br />POLICY NUMBER
<br />ImmioDfYYYY
<br />POL D XP
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERALLIABU -ITY
<br />CLAIMS -MADE M OCCUR
<br />6603K662699
<br />12!0112017
<br />kilo,
<br />1270 18
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGE TO RENTE
<br />PREMISES tEa occurrence
<br />$ 1,000,000
<br />MED EXP (Any one person).
<br />$ 10,000
<br />PERSONAL &ADVENJURY
<br />$ 1,000,000
<br />GEN'L AGGREGATE LIM IT APPLIES PER:
<br />X PRO -
<br />POLICY 1-1 PRC LOC
<br />OTHER:
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />PRODUCTS - COMPIOP AGG
<br />$ 2,000,000
<br />$
<br />A
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUTOS
<br />HIRED X NON -OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />BA3K669921 -
<br />1210112017
<br />1210112018
<br />COMBlNEDSINGLELIMIT
<br />Ea accldenl
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />80UlLY INJURY (Peraactdent)
<br />$
<br />X
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />X
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />C 0
<br />12101/2017
<br />12/01/2018
<br />EACH OCCURRENCE
<br />$ 25,000,000
<br />AGGREGATE
<br />$ 25,000,000
<br />DED X RETENTION $10 000
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANYPROPRIETORIPARTNERIEXECUTIVE
<br />OFFtCERfMEMBEREXCLUDED?
<br />(Mandatory In NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />B3RRJPffA
<br />1210112017
<br />12/01!2016
<br />X PER OTH-
<br />STATUTE ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. USEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,0(10,000
<br />❑
<br />Media Tech E &O& Cyber
<br />W15LZ6171201
<br />12101/2017
<br />12/0112018
<br />Limit
<br />Deductible
<br />10,000,000
<br />100,600
<br />DESCRIPTION OF OPERATION EHICLES (ACORD 141, Additional Remarks Schedule, may be attached If more space is required)
<br />CERTIFICATE BOLDER CANCELLATION
<br />For information Only SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />of Marsh USA Inc.
<br />Jon Lindstrom
<br />©1988 -2015 ACORD CORPORATION. All rights reserved.
<br />,,ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
<br />
|