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Home My WebLink AboutQWEST INTERPRISE - INSURANCE CERTIFICATEh A e R S� ; ., .- CERTIFICATE NUMBER E _ ! SEA-000259186-01 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS MARSH USA INC. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE THE FINANCIAL CENTER POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE 1215 FOURTH AVENUE AFFORDED BY THE POLICIES DESCRIBED HEREIN. SUITE 2300 SEATTLE, WA 98161-1095 COMPANIES AFFORDING COVERAGE Attn: Kathy B. Harid 206 613-2625 Fax 206 613-2516 COMPANY 00499-QGS-GAW-06-07 kbh cunt none A NATIONAL UNION FIRE INS CO OF PA INSURED COMPANY QW EST GOVERNMENT SERVICES, INC. B INSURANCE COMPANY OF THE STATE OF PA 1801 CALIFORNIA STREET, SUITE 1150 COMPANY DENVER, CO 80202 C AMERICAN HOME ASSURANCE COMPANY COMPANY D Co1�iAG�� ' , 9 aTrBpla¢eB�r�f pFre�ly Its �Dr a1a I �TNaNtd•6e 12. THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE tMMIDDIYY) POLICY EXPIRATION DATE (MMIDDIYY) LIMITS A GENERAL LIABILITY SEE ATTACHED 04/01/06 10101/07 GENERAL AGGREGATE $ 1,000,000 X PRODUCTS - COMP/OP AGO $ 1,000,000 COMMERCIAL GENERAL LIABILITY CLAIMS MADE I^ I OCCUR PERSONAL&ADV INJURY $ 1,000,000 EACH OCCURRENCE $ 1,000,000 OWNER'S & CONTRACTOR'S PROT FIRE DAMAGE (Any one fire $ 1,000,000 MED EXP (Any one pereartj $ 10,000 A AUTOMOBILE LIABILITY SEE ATTACHED (AOS) 04/01/06 10/01/07 COMBINED SINGLE LIMIT $ 1,000,000 X A ANY AUTO SEE ATTACHED (TX) 04/01/06 10/01/07 BODILY INJURY (Per person) $ A A ALL OWNED AUTOS SCHEDULED AUTOS SEE ATTACHED (VA) SEE ATTACHED CA CT LA NH NY 04/01106 10/01/06 10/01/07 10/01/07 X BODILY INJURY (Per accident) $ C HIREDAUTOS NON -OWNED AUTOS SEE ATTACHED (MA) 10/01/06 10/01/07 X X PROPERTY DAMAGE $ ELF -INSURED FOR UTO PHYSICAL DAMAGE GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY ANY AUTO EACHACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ UMBRELLA FORM $ OTHER THAN UMBRELLA FORM B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY SEE ATTACHED (AOS) SEE ATTACHED (CA) 04/01/06 04/01/06 10/01/07 10/01/07 X I TORYITATU LIMITS ER EL EACH ACCIDENT $ 1,000,000 EL DISEASE -POLICY LIMIT $ 1,000,000 A B THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE OFFICERS ARE: EXCL SEE ATTACHED (OR) SEE ATTACHED FL ( ) 04/01106 O4/O1/06 10/01/07 10I01/07 EL DISEASE -EACH EMPLOYEE $ 1,000,000 A OTHER Workers' Compensation SEE ATTACHED (ND,OH,WI) 04/01/06 10/01/07 Each AccidenttEmployee $1,000,000 A Workers' Compensation SEE ATTACHED (WV,WY) 04/01/06 10/01107 Each Accident/Employee $110001000 C Excess Workers' Compensation ISEE ATTACHED (WA) 04/01106 110101107 Excess of SIR Shown Above $1,000,000 DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/SPECIAL ITEMS RE: P871 Renewal 2007. Service agreement to provide maintenance of equipment & software for customer -provided equipment at various building locations. The City of Fort Collins, its officers, agents & employees are Additional Insureds as required by written contract on the General Liability Policy with respect to referenced service agreement. CERTI ICATE HOLDER CANCELLATION SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL _.__ DAYS WRITTEN NOTICE TO THE City of Fort Collins Purchasing 215 North Mason, 2nd Floor CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL MPOSE NO OBLIGATION OR P.O. Box 580 LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES, OR THE Fort Collins, CO 80522 ISSUER OF THIS CERTIFICATE. MARSH USA INC. n` BY: Cheryl) L. Koch L,/{ LUO(_ A a iYiMfj9lOZ) VALID AS OF: 04/16/07 PRODUCER MARSH USA INC. COMPANY THE FINANCIAL CENTER 1215 FOURTH AVENUE E SUITE 2300 SEATTLE, WA 98161-1095 COMPANY Attn: Kathy B. Harid 206 613-2625 Fax: 206 613-2516 F 100499-OGS-GAW-06-07 kbh cunt none INSURED COMPANY OW EST GOVERNMENT SERVICES, INC. 1801 CALIFORNIA STREET, SUITE 1150 G DENVER, GO 80202 COMPANY H POLICY TERM 4/1)06 TO 1011/06 General Liability Policy #GL3917172 Automobile Liability: Policy #CA3780043 (All Other States) Policy #CA3780042 (Texas) Policy #CA3768494 (Virginia) Workers' Compensation: Policy #W C4778329 (All Other States) Policy #W C4777998 (California) PolicytfWC4778331 (Florida) Policy #W C4778330 (Oregon) Policy#WC4778332 (North Dakota, Ohio, Wisconsin, West Virginia, Wyoming) Excess Workers' Compensation Policy #XW C4778869 (Washington) POLICY TERM: 10/1/06 TO 10/1/07 General Liability Policy #GL3948924 Automobile Liability: Policy #CA3818306 (All Other States) Policy#CA3817587 (Texas) Policy#CA3817586 Virrgginia) Policy #CA5836455California, Connecticut, Louisiana, New Hampshire, New York) Policy #CA5836580 (Massachusetts) Workers' Compensation: Policy #W C6611392 (All Other States) Policy #W C6611389 (California) Policy#WC6611391 (Florida) Policy #W C6611390 (Oregon) Policy#WC6611393 (North Dakota, Ohio, Wisconsin, West Virginia, Wyoming) Excess Workers' Compensation Policy #XW C6611394 (Washington) ;ATE HOLD" City of Fort Collins Purchasing 215 North Mason, 2nd Floor P.O. Box 580 Fort Collins, CO 80522 COMPANIES COVERAGE MARSH USA INC. BY Cheryll L. Koch dkL"41L yry 4'&k- DATE (MMIDDIYY) MARSHTt� CERTIFICATE NUMBER EA- 0291 -01 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS MARSH USA INC. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE THE FINANCIAL CENTER POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE 1215 FOURTH AVENUE AFFORDED BY THE POLICIES DESCRIBED HEREIN. SUITE 2300 SEATTLE, WA 96161-1095 COMPANIES AFFORDING COVERAGE - — - --- -- -- ------ -- _ Attn: Kathy B. Hand 206 613-2625 Fax 206 613-2516 COMPANY 00499-QGS-GAW-06-07 kbh cont none 1 A NATIONAL UNION FIRE INS CO OF PA INSURED - COMPANY QWEST GOVERNMENT SERVICES, INC. B INSURANCE COMPANY OF THE STATE OF PA 1801 CALIFORNIA STREET, SUITE 1150 DENVER, CO 80202 COMPANY C AMERICAN HOME ASSURANCE COMPANY COMPANY D THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO POLICY EFFECTIVE l POLICY EXPIRATION TYPE OF INSURANCE POLICY NUMBER LIMITS LTR DATE (MM/DD/YYI DATE (MM/DD/YYI A GENERAL LIABILITY SEE ATTACHED 04/01/06 10/01/07 GENERAL AGGREGATE I Y 1,000,000 j GENERAL LIABILITY X _ PRODUCTS COMP/OP AGG $ 1,000,0()0 j J CLAIMS MADE LX OCCURPERSONAL L & INJURY _$ 1,000,000 I 9COMMERCIAL OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Airy one fire) $— 1,000,000 MED EXP An one mon $ 10,00() A AUTOMOBILE LIABILITY SEE ATTACHED (AOS) 04/01/06 10/01/07 1 COMBINED SINGLE LIMIT I $ 1,000,000 A X ANY AUTO SEE ATTACHED (TX) 04/01/06 10/01/07 A ALL OWNED AUTOS SEE ATTACHED (VA) 04/01/06 10101J07 BODILY INJURY A SCHEDULEDAUTOS SEE ATTACHED CA CT LA NH NY 10/01/06 10/01/07 (Per pemon) is C X HIRED AUTOS SEE ATTACHED (MA) 10/01/06 10/01/07 1 BODILY INJURY r X (Peracddent)_ $ NON -OWNED AUTOS - - I X ELF -INSURED FOR -- --iPROPERTY DAMAGE $ UTO PHYSICAL DAMAGE GARAGE LIABILITY AUTO ONLY- EA ACCIDENT $ ANYAUTO OTHER THAN AUTO ONLY EACH ACCIDENT $_ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE _ $ -- _i UMBRELLA FORM AGGREGATE OTHER THAN UMBRELLA FORM $ ND SEE TACHED AOS B WORKERS COMPENSATION AAT( ) WC STATU- OTH- 04/01/U6 10/01/07 X. TOLIMITS ER EMPLOYERS' LIABILITY , B SEE ATTACHED (CA) 04/01/06 10/01/07 EL EACH ACCIDENT $ 1,000,000 A THE PROPRIETOR! I INCL SEE ATTACHED (OR) PARTNERS/EXECUTIVE F 04/01/06 10/01/07 EL DISEASE-POLICY_LIMFF I $ 1,000,000 SEE ATTACHED ( B OFFICERS AREFL : EXCL ) 04/01/O6 11)101/07 ELDISEASE-EACHEMPLOYEE'$ 1,000,000 IOTN R A Workers' Compensation SEE ATTACHED (ND,OH,Wq 04/01/06 10/01/07 Each AccidenVEmployee $1,000,000 A iWorkers'Compensation SEE ATTACHED(WV,WY) 04/01/06 10/01/07 Each Accident/Employee $1,000,000 C Excess Workers' Compensation SEE ATTACHED (WA) 04101 F06 10/01/07 !Excess of SIR Shown Above $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS RE: P871 Renewal 2007. Service agreement to provide maintenance of equipment & software for customer -provided equipment at various building locations. The City of Fort Collins, its officers, agents & employees are Additional Insureds as required by written contract on the General Liability Policy with respect to referenced Service agreement. CUTIFIOA"M 14OLDER '; CANCIE"TION SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL _-_W DAYS WRITTEN NOTICE TO THE City of Fort Collins Purchasing 215 North Mason, 2nd Floor CERTIFICATE HOLDER NAMED HEREIN. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR P.O. Box 580 LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, CS AGENTS OR REPRESENTATIVES, OR THE Fort Collins, CO 80622 ISSUER OF THIS CERTIFICATE. MARSH USA INC. eY: Cheryll L. Koch N,Gtr� °NRA7(4 M) VALID AS OF: 04/16/07 DATE (MMIDD/YY) 04/16/07 PRODUCER COMPANIES AFFORDING COVERAGE MARSH USA INC. — — — ------------- — -- THE FINANCIAL CENTER COMPANY 1215FOURTH AVENUE E SUITE 2300 SEATTLE, WA 98161-1095__— Attn: Kathy B. Hariri 206 613-2625 Fax: 206 613-2516 COMPANY F 100499-QGS-GAW-06-07 kbh cont none INSURED COMPANY QWEST GOVERNMENT SERVICES, INC. 1 B01 CALIFORNIA STREET, SUITE 1150 G DENVER, CO 80202 COMPANY H POLICY TERM 411 /06 TO 10/1106 General Liability Policy #GL3917172 Automobile Liability: Policy #CA3780043 (All Other States) Policy #CA3780042 (Texas) Policy #CA3768494 (Virginia) Workers' Compensation: Policy #WC4778329 (Ail Other States) Policy #WC4777998 (California) Policy#WC4778331 (Florida) Policy #WC4778330 (Oregon) Policy #WC4778332 (North Dakota, Ohio, Wisconsin, West Virginia, Wyoming) Excess Workers' Compensation Policy #XWC4778869 (Washington) POLICY TERM: 10/1/06 TO 10/1/07 General Liability Policy #GL3948924 Automobile Liability: Policy #CA3818306 (All Other States) Policy #CA3817587 (Texas) Policy #CA3817586 (Virginia) Policy #CA5836455 (California, Connecticut, Louisiana, New Hampshire, New York) Policy #CA5836580 (Massachusetts) Workers' Compensation: Policy #WC6611392 (All Other States) Policy #WC6611389 (California) Policy#WC6611391 (Florida) Policy #WC6611390 (Oregon) Policy #WC6611393 (North Dakota, Ohio, Wisconsin, West Virginia, Wyoming) Excess Workers' Compensation Policy#XWC6611394 (Washington) City of Fort Collins Purchasil 215 North Mason, 2nd Floor P.O. Box 580 Fort Collins, CO 80522 MARSH USA INC. BY Cheryll L. Koch tk culu{ 1�i