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) ) ) .J ) ) ) -, ) } ) ) ) ) ) ) ) Stanley Consultants Inc. ~ ,RFQ N 12 04 03 A t' E SCCOM-1 OP 10: CH C It' S f T C t Sk t P k ACORD o. C-ERTIFICAgfEIOFnLIASILirv INSeuRANCE I DATE (MMlDDfYYYV) ~ 01/10/12 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. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must 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 certlflcate holder In lieu of such endorsemonlCsl. PRODUCER 563.263.6044 CONTACT NAME: Miller & Harrison Insurance 563-263.6667 rA~gNJn I'YlI' IrM Nol: 100 W. Second St. Muscatlne, IA 52761 ~~D~~SS' Michael Harrison INSURERrSI AFFORDING COVERAGE NAIC# INSURER A: Phoenix Insurance Company 25623 INSURED Stanley Consultants, Inc. INSURER B: Charter Oak Fire Ins. Co. 25615 1641 Worthington Road #400 INSURER c: Travelers ProperlY Cas. 25674 West Palm Beach, FL 33409 INSURER D: CNA Insurance Companies 20443 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. I~f: TYPE OF INSURANCE POLICY NUMBER ~ ,r-P.!;IC)~ LIMITS MMlDD GENERAL LIABILITY EACH OCCURRENCE S 1,000,OOC - A ~ OERCIAL GENERAl LIABILITY 630-4885B479.TIL.12 01/01/12 01/01/13 PREMISES lEa occurrencel $ 1.000,00C - CLAIMS-MAlJE [lU OCCUR MED EXP (MY one parson) $ 10,OOC - PERSONAL & /lJJV INJURY $ 1.000,000 GENERAL AGGREGATE $ 2.000,000 - 2.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ ~. POLICY !Xl P'~RT n LOC S AUTOMOBilE LIABILITY &~~~~INGlE LIMIT S 1.000,OOC - 810-4885B479-COF-12 01/01/12 01/01/13 BODilY INJURY (Per par~on) B ~ ANY AlITO S All OWNED X SCHEDULED ~ AUTOS AUTOS BODilY INJURY (Per accident) $ X NON-OWNED rp~~~~~I?MlAGE ~ HIRED AUTOS ..;..;;.. AUTOS $ I S ~ UMBRELLA L1AB ~ OCCUR EACH OCCURRENCE $ 20,000,000 C EXCESS UAB CLAIMS.MADE CUP-48B5B479.TIL.12 01/01/12 01/01/13 AGGREGATE s 20.000,000 OED I X I RETENTION S 10,000 $ WORKERS COMPENSATION X WCSTATU-.I IOJ~- AND EMPLOYERS' UABIUTY Y/N 1,000,000 B A!-f'f PROPRIETORlPARTNERlEXEClITlVE D PVYBOUB-4885B47 -9-12 01/01/12 01/01/13 E.L EACH ACCIDENT $ OFACERnJEMBER EXCLUDED? NfA 1,000,000 (Mandatory In NHI E.L DISEASE. EA EMPLOYEE $ If ~e$. describe unde, E.L DISEASE - POLICY LIMIT S 1,000,000 o SCRIPTION OF OPERATIONS below D Professional AEH 00 822 09 75 10/05/11 10/05/12 Per Claim 20,000.00~ Liability CLAIMS-MADE FORM Aggregate 20,000,000 DESCRIPTION OF OPERATIONS f LOCATIONS fVEHICLES (Attach ACORD 101, Addll10nll Reml"'s Schedule,lrmore space Is required) CERTIFICATE HOLDER CANCELLATION SPEC001 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE SPECIMEN THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE I ~J~ ACORD 25 (2010/05) @1988.2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 4