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Home My WebLink AboutBOULDER DESIGN ALLIANCE ROB DEKIEFFER - INSURANCE CERTIFICATE (2)ACORD. CERTIFICATE OF LIABILITY INSURANCE °ATE 11-01-2006 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION VAN GILDER INSURANCE CORP/PHS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 341438 P: (866)467-8730 F: (877) 905-0457 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO BOX 33 015 SAN ANTONIO TX 78265 INSURERS AFFORDING COVERAGE INSURED '.INSURERA:Hartford Casualty Ins Co BOULDER DESIGN ALLIANCE MR. ROB INSURER B: DEKI EFFER INSURER C: 3002 MELISSA LN. INSURER D: BOULDER CO 80301 INSURER E: COVERAGES 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 rypE OF INSURANCE POLICY NUMBER L POLICY EFFECTIVE POLICY EXPIRATION DATE MM/DD/YV DATE MM/DDIYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $1, 0 0 0, 0 0 0 A COMMERCIAL GENERAL LIABILITY 34 SBA LJ6557 01/01/07 01/01/08 FIRE DAMAGE (Any one fire) s300, OOO CLAIMS MADE U OCCUR MED EXP (Any one person) $1 0 , 000 X Business Liab PERSONAL& ADV INJURY $1, 000, 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 POLICY X PRCTO LOC JE A AUTOMOBILE LIABILITY ANY AUTO 34 SBA LJ6557 01/01/07 COMBINED SINGLE LIMIT 01/01/08 IEa accident) $1 O O O O O O $ ALL OWNED AUTOS SCHEDULED AUTOS ! BODILY INJURY (Per person) HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) X $ X $ PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ ANY AUTO $ EXCESS LIABIL17Y OCCUR a CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ $ DEDUCTIBLE $ i RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC STATU- I OTH,, TORY LIMITS R E.L. EACH ACCIDENT g I E.L. DISEASE - EA EMPLOYEE'S $ E.L. DISEASE -POLICY LIMIT S OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Those usual to the Insured's Operations. CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 45 DAYS WRITTEN NOTICE (10 DAYS FOR NON-PAYMENT) TO THE CERTIFICATE City of Fort Collins HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO 256 W Mountain Ave OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Fort Collins, CO 80521 A ORI D R ESE�N�]ATI1C��- ACORD cD-a (i/97) O ACORD CORPORATION 1988 VAN GILDER INSURANCE CORP/PHS PO BOX 33015 SAN ANTONIO TX, 78265 City of Fort Collins 256 W Mountain Ave Fort Collins, CO 80521 ACORD 26-S (7/97) ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE 11-01-2006 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION VAN GILDER INSURANCE CORP/PHS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 341438 P: (866)467-8730 F: (877)905-0457 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO BOX 33015 SAN ANTONIO TX 78265 INSURERS AFFORDING COVERAGE INSURED INSURERA:Hartford Casualty Ins Co BOULDER DESIGN ALLIANCE MR. ROB INSURER B: DEKIEFFER INSURER C: 3002 MELISSA LN. INSURER D: BOULDER CO 80301 INSURER E: COVERAGES 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 LTR rypE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DO(YV POLK:Y EXPIRATION LIMITS DATE MM(DD/YY GENERAL LIABILITY iI EACH OCCURRENCE I $1 r 0 0 0 r 0 0 0 A COMMERCIAL GENERAL LIABILITY 34 ,-SBA LJ6 5 5 7 01 / 01 / 0 7 01 / 0 1/ 0 8 FIRE DAMAGE (Any one fire) s300,000 CLAIMS MADE X OCCUR MED EXP IAr y one person) $10 , 0 0 0 X Business Liab PERSONAL &ADV INJURY $1r 000r 000 GENERAL AGGREGATE s2,000,000 PRODUCTS - COMP/OP AGG 52 r 0 0 0 r 0 0 0 GENT AGGREGATE LIMIT APPLIES PER: i POLICY X I PECT RO- LOC J AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 A ANY AUTO 34 SBA LJ6557 01/01/07 01/01/081 (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS Wer person) X HIRED AUTOS BODILY INJURY $ X NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT I $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ ` OCCUR Ll CLAIMS MADE AGGREGATE $ S DEDUCTIBLE 15 RETENTION $ 5 WORKERS COMPENSATION AND WCTOR STATU- IMITS ER EMPLOYERS ' LIABILITY !T E.L. EACH ACCIDENT 5 E.L. DISEASE - EA EMPLOYEE ! $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Those usual to the insured's operations. CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER: _ CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL City of Fort Collins 45 DAYS WRITTEN NOTICE (10 DAYS FOR NON-PAYMENT) TO THE CERTIFICATE Attn : Jan Elliott HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 256 W. Mountain Avenue REPRESENTATIVES. Fort Collins, CO 80521 AUIIF4O ESEN ATI i ACURD 25-S (71971 0 ACORD CORPORATION 1988 VAN GILDER INSURANCE CORP/PHS PO BOX 33015 SAN ANTONIO TX, 78265 City of Fort Collins Attn: Jan Elliott 256 W. Mountain Avenue Fort Collins, CO 80521 ACORD 25-S (7/97)