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Home My WebLink AboutHUDSPETH - INSURANCE CERTIFICATEACORD CERTIFICATE OF DATE (MM/ LIABILITY INSURANCE DCSR SP-1 HU02 06/ 08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Forsberg Engerman Company HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR 3575 S Sherman St ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Englewood CO 80113 Phone 303-762-1717 INSURERS AFFORDING COVERAGE NAIC # NSURED INSURER pmar can lot 1 specialty L nee HAttnudspeth 6 Inc INSURER Pinnacol Assurance rt Levitt Robert Levitt INSURER E y a�Loye a Mutual Casualty co 4775 S Santa Fe Circle Englewood Englewood CO 80112 INSURERD INSURER E 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 MATH 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 LT NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD DATE MWDD/YY LIMITS 7 GENERAL LIABILITY EACH OCCURRENCE $1000000 X X COMMERCIAL GENERAL LIABILITY PROP3778989 12/17/07 12/17/08 AMXA PREMISES(Eaoccurence) $ 300000 CLAIMS MADE OCCUR MED EXP(Any one person) $25000 X Pollution Llab PROP3778989 12/17/07 12/17/08 PERSONAL $1000000 X XCU Included _BADVINJURY GENERAL AGGREGATE $ 1000000 GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS COMP/OPAGG $1000000 X POLICY jE�T LOC Prof Llab 1000000 AUTOMOBILE LIABILITY C ANY AUTO 2ES548609 02/04/08 02/04/09 COMBINED SINGLE LIMIT (Ea accident) $1000000 X ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) C HIRED AUTOS 2E8548609 02/04/08 02/04/09 X X C NON -OWNED AUTOS 2ESS48609 02/04/08 02/04/09 BODILY INJURY (per'=dent) $ 1000000 PROPERTY DAMAGE (Per accident) $ 1000000 GARAGE LIABILITY AUTOONLY EAACCIDENT $ ANYAUTO OTHER THAN EAACC $ $ AUTO ONLY AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $4000000 A X OCCUR CLAIMSMADE PROU9964023 12/17/07 12/17/08 AGGREGATE $ 4000000 DEDUCTIBLE S X RETENTION $ 10000 $ WORKERS COMPENSATION AND X TORV LIMITS X ER B EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNEWEXECUTIVE 4064674 01/01/08 01/01/09 EL EACH AccIpENT $ 1000000 OFFICER/MEMBER EXCLUDEDo Ira. Ir. desenbe under EL DISEASE EA EMPLOYEE $ SOOOOOO EL DISEASE POLICY LIMIT 1 $ 1000000 PROVISIONS below OTHER C BPP 2A8548609 02/04/08 02/04/09 Limit $80000 C Lease/Rented E9212 1 2CS546609 DEDUCTIBLE $500 02/04/08 02/04/09 Limit $345000 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS City Of Fort Collins is named as an Additional Insured with respect to General Liability coverage City of Fort Collins 215 N Mason St, 2nd Floor PO Box 580 Fort Collins CO 80522-0580 CITFORT I 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 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES (2001108)