CC - Agendas - City Council - REGULAR - 8/14/2018

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ACORDTU 9.F.a DATE (MMIDD/YYYV) 3/15/2018 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. Client#: 53946 DIBBASSOC CERTIFICATE OF LIABILITY INSURANCE IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must have ADDRIONAL 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER Greyling Ins. Brokerage/EPIC 3780 Mansell Rd. Suite 370 Alpharetta, GA 30022 INSURED Dibble & Associates Consulting 7878 N. 16th St., Ste. 300 Phoenix, AZ 85020 COVERAGES CERTIFICATE NUMBER: 17- CONTACT Trudy nenry PHONE 770.552.4225 I (A/C. No Ext): EMAIL +rudy.henry@greyling.com ADDRESS: Y ry@greyling.com FAX IA/C. No INSURER(S) AFFORDING COVERAGE INSURER A : Prop.rty a C.su.lty Ins Co of Hartford INSURER 8 : 866.550.4082 Ts O 34690 a 0. NAIC K INSURER C: INSURER D INSURER E I INSURER F : 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 TYPE OF INSURANCE ADOLISUBR JNSR WVD POLICY NUMBER POLICY EFF (MM/DO/YYYY) POLICY EXP (MMIDO/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY _EACH $ CLAIMS -MADE OCCUR �S (EOCCURRENCE PRAEMISEa occurrence} $ MED EXP (Any one person) 5 PERSONAL. & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: PRO - I JECT 7 LOC GENERAL AGGREGATE 5 PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE _ UABIUTY 1-1 SCHEDULED AUTOS NON -OWNED I i AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident) S BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAR EXCESS LIAB O OCCUR CLAIMS -MADE ( EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEr— OFF10ER/MEMBER EXCLUDED? NI (Mandatory In NH) '—' It yes, describe under DESCRIPTION OF OPERATIONS below N / A 84WBGCB5943 11/01/2017 11/01/2018 X iSTATUTE ERH E.L. EACH ACCIDENT 51,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORO 101, Additional Remarks Schedule, may be attached if more apace is required) Re: Prescott Municipal Airport Design and Engineering Services RSOQ#18AP002 CERTIFICATE HOLDER CANCELLATION City of Prescott and Prescott Municipal Airport Director 6546 Crystal Lane Prescott, AZ 86301 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 E ._ 2/t Packet Pg. 179