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

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9.F.a DIBBL-1 CERTIFICATE OF LIABILITY INSURANCE DATE (MN/ODLYYYY) 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 POLICES 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 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 endorsement(s). PRODUCER 602-264-5533 Stuckey Ins & Assoc Agencies 2850 E Came!back Rd, Suite 325 Phoenix, AZ 85016 Scott Schmidt c TACT Teresa Alvarado PHONE (CNN Ext): 602-264-5533 I ( , No) 602-279-9336 6D-It ss teresa.alvarado@stuckeyinsurance.com INSURERLS) AFFORDING COVERAGE NAIC N INSURER A • Berkley Insurance Company '32603 INSURED Dibble & Associates Consulting 7878 N. 16th St., Ste. 300 Phoenix, AZ 85020 INSURER e INSURER C : INSURER D : INSURER E : INSURER F : 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 OF INSURANCE ATYPE , pL WVp POLICY NUMBER POLICY EFF LMMlY lDOYYYJ POLICY EXP (MMLDLNYYYYI LIMITS COMMERCIAL GENERAL UABILITY • EACH OCCURRENCE 1 $ CLAIMS -MADE OCCUR DAMAGE TO RENTED I l PREMISES (Ea occurrence) , $ i MED EXP (Any one person) , $ PERSONAL & ADV INJURY $ GENT AGGREGATE UMR APPLIES I 1 PEP t PER. LOC I GENERAL AGGREGATE i $ PRODUCTS - COMP/OP AGG , $ I I S AUTOMOBILE LIABILITY SCHEDULED AUTOS yyNED AUTOS ONLY I COMBINED SINGLE LIMIT l (Ea accident) $ . BODILY INJURY (Per person) $ I BODILY INJURY (Per accident) $ (Per accident) DAMAGE $ $ UMBRELLA LIAB EXCESS LAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE . ,3 AGGREGATE $ $ DEO j I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPREIETgOER/PARTNER/EXECUTIVE 0FFII ER/MEn NH) EXCLUDED? i I NH If ea describe under DESCRIPTION OF OPERATIONS below N / A L STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE • EA EMPLOYEE 5 E.L. DISEASE - POLICY LIMIT $ A Professional Liab AEC-9020878-00 02/28/2018 02/28/2019 Per Claim Aggregate 5,000,00C 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule. may be attached if more space is required) Professional Liability - Claims Made - Retro Date 10/31/1962 Re: Prescott Municipal Airport Design and Engineering Services RSOQ#18AP002 CERTIFICATE HOLDER CZPRE-1 City of Prescott Prescott Municipal Airport Director 6546 Crystal Lane Presott, AZ 86301 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE W1TH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE I � Ar rsl L f 1 .- © 1988-2015 ACORD CORPORATION. ALl'aCket Pg. 178 ACORD 25 (2016/03)