HomeMy WebLinkAboutRESOURCE ONE TERRA FIRMA - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE OP ID J DATE(MMIDDNYYY)
RESOD-4 01 29 07
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Diversified Insurance Brokers ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
of Utah HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
136 E South Temple Ste 2300 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Salt Lake City UT 84111
Phone:801-325-5000 Fax:801-532-2804
Resource One, LLC
dba Terra Firma
600 Grant Street, Suite 700
Denver CO 80203
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INSURERS AFFORDING COVERAGE
INSURER A: Pinnacol Assura
INSURER B:
INSURER C:
INSURER D:
INSURER E:
NAIC #
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INUK
LTR
AW
INS9
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIDD
POLICY EXPIRATION
DATE (MMIDOrrn
LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 7OCCUR
EACH OCCURRENCE
$
PREMISES Ea ocarcnce
$
MED EXP (Any one person)
$
PERSONAL &ADV INJURY
$
GENERAL AGGREGATE
$
GEN'L AGGREGATE LIMIT APPLIES PER
17 POLICY JEa LOC
PRODUCTS -COMP/OPAGG
$
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
COMBINED SINGLE LIMB
(Ea accident)
$
BODILY INJURY
(Per person)
$
BODILY INJURY
(Par accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
I
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
EXCESSIUMBRELLA LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
S
$
$
A
WORKERS COMPENSATION AND
ANY PROPRIETORIETOREMPLOYER1LITYIPARTNERIEXECl1TIVE
OFFICERIMEMBER EXCLUDED?
H yes describe under
SPECIAL PROVISIONS below
4038719
01/01/07
01/01/08
ATI
X TORY LIMITS ER
E.L. EACH ACCIDENT
$ 1000000
E.L. DISEASE -EA EMPLOYE
$1000000
E.L. DISEASE -POLICY LIMIT
$1000000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
This certificate shows that H & H Data Services, Inc. is covered under the
workers' compensation policy issued to Resource One, LLC dba Terra Firma.
HOLDER
City of Fort Collins
P.O. Box 580
Fort Collins CO 80522-0580
H&HDATA I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAUL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY IOND UPON THE INSURER, ITS AGENTS OR
® ACCORD CORPORATION 1