HomeMy WebLinkAboutRESOURCE ONE - INSURANCE CERTIFICATEACORD_ CERTIFICATE OF LIABILITY INSURANCE OP ID J DATE(MMIODNYYY)
RESOU-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 T— le Ste 2300 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
• r
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
Pf%1102AGPS
INSURERS AFFORDING COVERAGE
INSURER A: Plnnacol 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.
LTR
NS
TYPE OF INSURANCE
POLICY NUMBER
DATE MMIDD
DATE MMIDD
LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 7 OCCUR
EACH OCCURRENCE
$
PREMISES Ea occtrence
$
MED EXP (Any one person)
1 $
PERSONAL A ADV INJURY
$
GENERAL AGGREGATE
$
GENL AGGREGATE LIMIT APPLIES PER:
17 POLICY JECOT LOC
PRODUCTS-COMP/OP AGG
$
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
COMBINED SINGLE LIMB
(Ea accident)
$
BODILY INJURY
(�B person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
rl
GARAGE LIABILITY
ANYAUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EAACC
AUTO ONLY: AGG
$
$
EXCESSAIMBRELLA LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
$
$
A
WORKERS COMPENSATION AND
EMPLOYERIETOR/Lmr
ANYPROPRIETORlEXCLUDE EXECUTIVE
OFFICERIMEMBER EXCLUDED?
M yyeess describe under
SPECIALPROVISIONS below
4038719
-
01/01/07
01/01/08
Ulm -
X I TORY LIMITS I ER
E.L. EACH ACCIDENT
$1000000
E.L. DISEASE - EA EMPLOYE
$ 1000000
E.L. DISEASE -POLICY LIMIT
—
$1000000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I 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.
t-cecnrlcAIt nULLJt:K CANCELLATION
H &HDATA 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 DO SO SHALL
City Of Fort Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
P.O. Box 580 REPRESENTATIVES.
Fort Collins CO 80522-0580 A - REPRESENTATIVE
1988