HomeMy WebLinkAbout280698 NORTH STAR DESIGN INC - INSURANCE CERTIFICATENORSIA/
4J1/I
L,11U111.fDATE
ACO DTM CERTIFICATE
OF LIABILITY
INSURANCE
10/11/07 (MMIDDnv)
PRODUCER
Van Glider Insurance Corp
700 Broadway, Suite 1000
THIS CERIIFICATE 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 AFFORDED BY THE POLICIES BELOW
_COVERAGE
INSURERS AFFORDING COVERAGE
Denver, CO 80203
303 837-8500
INSURED
INSURERA
Hartford Accident & Indemnity Co
INSURER
Everest National Insurance Company
North Star Design, Inc
wsuRER c
700 Automation Dr , Unit 1
Windsor, CO 80550
INSURERD
INSURFR E
I:UV CKA`I
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
Ir__�
INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIDDnV
POLICY EXPIRATION
DATE MMID IYY
LIMITS
ITY
EACH OCCURRENCE
$
FIRE DAMAGE(Anyone file)
E
AL GENERAL LIAR IL ITY
MED EXP (Any one person)
$
S MADE OCCUR
PERSONAL & ACV INJL"'Y
$
GENERAL AGGREGATE
$
PRODUCTS-COMPIOPAGG
$
TE LIM ITAPIPLILIEES PER
,EOT LOC
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
(Ea accident)
$
ANY AUTO
ALL OWNED AUTOS
BODILY INJURY
(Per Person)
$
SCHEDULED AUTOS -
BODILY INJURY
(Per accident)
$ -
HIRED AUTOS
NON -OWNED AUTOS
PROPERTYDAMAGE
(Per accident)
E ,
•
- , -
GARAGE LIABILITY
AUTO ONLY,'EA ACCIDENT
$
OTHER�THAN EA ACC
AUTO ONLY AGO
$ -
,ANY AUTO
$
EXCESS LIABILITY
EACH OCCURRENCE
$
AGGREGATE
$
OCCUR CLAIMS MADE
E
$
DEDUCTIBLE
$
RETENTION $
A
WORKERS COMPENSATION AND
34WEGKDO139
09/01/07
09/01/08
X We sTAru- orH-
E L EACH ACCIDENT
$1,000,000
EMPLOYERS' LIABILITY
EL DISEASE -EA EMP.OYEE
41,001
EL DISEASE -POLICY LIMIT
1 $1,000,000
B
OTHER Professional
48AE003420071
09/01/07
09/01/08
$1,000,000 per claim
Liability
$1,000,000 annl aggr
laims Made
DESCRIPTION OF OPER nONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
City of Fort Collins
Purchasing Division
PO BOX 580
Fort Collins, CO 80522-0580
SHOULD ANY OF THE ABOVE D ESC RIB ED POLICIES B E CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOWJJ,30_ DAYS WRJTTEN
NOTICE TO THE CERTIFICATE HOLD ERNAM ED TO THE LEFT, BUT FNLURE TOD O SO SHALL
IMPOSE NO OU LIGATION OR LIABILITY OF ANY KIND UPON THE INSURE RJTS AGENTS OR
.Izd
ACORD 25-5 (7197)1 of 1 #M511432 RAC " I.—
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) most be endorsed A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s)
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s)
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon
ACORD 25 (2001/08)