Loading...
HomeMy WebLinkAbout210513 ODIN SERVICES LLC - COI and WC12418051 Odin Services LLC Certificate Of Insurance 8/10/2022 5:43:58 PM ---oft A��� �® C�?CERTIFICATE OF LIABILITY INSURANCE FDAATE/11MMIDDIYYYY) 80/2022 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. POLICY NUMBER 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 endorsements . PRODUCER CONTACT NAME: AICNNo Ext): (800) 688-1984 A/C No): 312-690-4123 E-MAIL yr insureon Insureon (BIN Insurance Holdings LLC.) ADDRESS: CLAIMS -MADE 1/1 OCCUR 30 N. LaSalle, 25th Floor, Chicago, IL 60602 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: ACUITY A Mutual Insurance Company 14184 $ 10,000 INSURED INSURER B: Liberty Mutual Insurance Company 23043 INSURER C: ACUITY A Mutual Insurance Company 14184 Odin Services LLC INSURER D: Western Surety Company $ 1,000,000 13188 2754 Quarterland St, Strasburg, CO, 80136 INSURER E: Ohio Casualty Insurance Company 24074 1/18/2022 INSURER F: Ohio Casualty Insurance Company AGGREGATE LIMIT APPLIES PER: 24074 $ 3,000,000 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 MMIDD/YYYY POLICY EXP MMIDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE 1/1 OCCUR PREM SES (Ea occurDrence) $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 A ZL8850 1/18/2022 1/18/2023 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 GEN'L ✓ POLICY ❑JECT PRO ❑ LOC PRODUCTS - COMP/OP AGG $ 3,000,000 $ OTHER: AUTOMOBILE LIABILITY COEaMBINED ccident SINGLE LIMIT a $ 1,000,000 BODILY INJURY (Per person) $ ✓ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS ZL8850 5/31/2022 1/18/2023 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ C WORKERS COMPENSATION✓ AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? No NIA ZL8850 1/18/2022 1/18/2023 PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below 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) CERTIFICATE HOLDER CANCELLATION The City of Wheat Ridge 11220 W 45th Ave Wheat Ridge, CO 80033 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 - r1-�-� © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 12418051 Odin Services LLC Certificate Of Insurance 8/10/2022 5:43:58 PM ---oft A��� �® C�?CERTIFICATE OF LIABILITY INSURANCE FDAATE/11MMIDDIYYYY) 80/2022 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. POLICY NUMBER 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 endorsements . PRODUCER CONTACT NAME: AICNNo Ext): (800) 688-1984 A/C No): 312-690-4123 E-MAIL yr insureon Insureon (BIN Insurance Holdings LLC.) ADDRESS: CLAIMS -MADE 1/1 OCCUR 30 N. LaSalle, 25th Floor, Chicago, IL 60602 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: ACUITY A Mutual Insurance Company 14184 $ 10,000 INSURED INSURER B: Liberty Mutual Insurance Company 23043 INSURER C: ACUITY A Mutual Insurance Company 14184 Odin Services LLC INSURER D: Western Surety Company $ 1,000,000 13188 2754 Quarterland St, Strasburg, CO, 80136 INSURER E: Ohio Casualty Insurance Company 24074 1/18/2022 INSURER F: Ohio Casualty Insurance Company AGGREGATE LIMIT APPLIES PER: 24074 $ 3,000,000 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 MMIDD/YYYY POLICY EXP MMIDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE 1/1 OCCUR PREM SES (Ea occurDrence) $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 A ZL8850 1/18/2022 1/18/2023 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 GEN'L ✓ POLICY ❑JECT PRO ❑ LOC PRODUCTS - COMP/OP AGG $ 3,000,000 $ OTHER: AUTOMOBILE LIABILITY COEaMBINED ccident SINGLE LIMIT a $ 1,000,000 BODILY INJURY (Per person) $ ✓ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS ZL8850 5/31/2022 1/18/2023 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ C WORKERS COMPENSATION✓ AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? No NIA ZL8850 1/18/2022 1/18/2023 PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below 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) CERTIFICATE HOLDER CANCELLATION The City of Wheat Ridge 11220 W 45th Ave Wheat Ridge, CO 80033 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 - r1-�-� © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD