HomeMy WebLinkAboutBOULDER DESIGN ALLIANCE - INSURANCE CERTIFICATE (3)JGJj
ACORD,a CERTIFICATE OF LIABILITY INSURANCE P1DC 12-01TE2006
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: (86 6) 467-8730 F : (877) 905-0457 ALTER THE COVERAGE AFFORDED BY THE POLICIES RFI OW.
PO BOX 33015
SAN ANTONIO TX 78265 INSURERS AFFORDING COVERAGE
NSLMFD INSURER A:Hartford Casualtv Ins Co
BOULDER DESIGN ALLIANCE MR. ROB INSURER B:
DEK I E F FER INSURER C:
.3002 MELISSA LN. INSURERD:
l.UVtHAI3tJ
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.
MISR
TYPE OF INSMRAM^.E
POLICY MLMBER
POLICYEFFECTIVE
(MMA)DIVY)
POUCVEXPMATMDATE
LAM WMW/YV)
LMnS
GOVERAL LIARRITY
EACH OCCURRENCE
$1 0 0 O 0 0 O
A
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE O OCCUR
34 SBA LJ6557
01/01/06
01/01/07
FIRE DAMAGE (Any weMe)
2300,000
MED EXP (Arty one person)
$1 O 0 0 O
X Business Liab
PERSONAL & ADV INJURY
$1 OOO OOO
GENERAL AGGREGATE
$ 2 0 0 O 000
GENT AGGREGATE
LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2 0 0 O 000
POLICY X
PRO LOC
AUTOMOBILE
LIARIITY
A
ANY AUTO
34 SBA LJ6557
01/01/06
01/01/07
COMBINED LE LIMIT
(Ea aceidannt) U
$1 000 000
I
BODILY INJURY
(Per pawn)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
X
BODILY INJURY
(Per accidem)
$
X
PROPERTY DAMAGE
(Per accidem)
$
GARAGE UARRITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESSUARIUTV
EACH OCCURRENCE
$
AGGREGATE
$
OCCUR CLAIMS MADE
S
$
DEDUCTIBLE
RETENTION $
WORRIERS COMPENSA 770M AND
WC STATU- OTH-
EMPLOYERS' LIABRnY
E.L. EACH ACCIDENT
$
E.L. DISEASE - FA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERA T/ONSILOCA TIONS VEHICLESIEXCLUVONS ADDED BY ENDORSEM£NTISPEL]AL PROVISIONS
Those usual to the Insured's Operations.
f`FRTICIn ATF LJnI nC0 ......r....... ............ ......�__.____ ....... �.. .r. �..
City of Fort Collins
PO Box 580
Fort Collins, CO 80522
DULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
'IGATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
DAYS WRITTEN NOTICE 00 DAYS FOR NON-PAYMENT) TO THE CERTIFICATE
LDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO
-IGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
'RESENTATIVES.
REPRESENTA nVE
" "' """' C ACORD CORPORATION 1988