HomeMy WebLinkAboutSKUMATZ - INSURANCE CERTIFICATE (3)ACORDM CERTIFICATE OF LIABILITY INSURANCE
03io6/2 o 1
PRODUCER (303)442-1484 FAX (303)442-8822
Taggart & Associates, Inc.
1600 Canyon Boulevard
P. 0. Box 147
Boulder, CO 80306
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED SKUMATZ ECONOMIC RESEARCH ASSOCIATES, INC.
762 ELDORADO DRIVE, STE 100
SUPERIOR, CO 80027
INSURERA: Hartford Casualty Insurance Co
29424
INSURERS Twin City Fire Ins Co
29459
INSURER C:
INSURER D:
INSURER E:
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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.
INSR
ADD`
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MWDD/YY)
POLICY EXPIRATION
DATE imminnnNi
LIMITS
GENERAL LIABILITY
34SBAPA5100
03/12/2007
03/12/2008
EACH OCCURRENCE
$ 2,000,00
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
$ 300,00
CLAIMS MADE I OCCUR
MED EXP (Any one person)
$ 10,000
A
PERSONAL & ADV INJURY
$ 2,000,000
GENERAL AGGREGATE
$ 4,000,000
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 4,000,000
POLICY PR0-
JECT LOC
AUTOMOBILE
LIABILITY
ANY AUTO
34SBAPA5100
03/12/2007
03/12/2008
COMBINED SINGLE LIMIT
(Ea accident)
$
2,000,000
BODILY INJURY
(Per person)
$
A
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
$
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION AND
34WECGM5199
03/12/2007
03/12/2008
wcsrnru-
ITOR
B
EMPLOYERS'LIABILITY
ANY PROPRIETORIPARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$ 100,000
E.L. DISEASE - EA EMPLOYEE
$ 100,000
OFFICERIMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE -POLICY LIMIT
$ S00,00
00 , 00
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VE ICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
t is agreed that the Certi icate Nolder named below is included as an Additional Insured for
eneral Liability.
City of Fort Collins
Attn: James B. O'Neill - Purchasing
P.O. Box 580
Fort Collins, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER. ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE ` �,,,,./�
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ACORn 25 r2ani/nR1 FAX: (970)221-6707
(MACnRn CnRPORATION 9RRR