HomeMy WebLinkAboutOPTIO SOFTWARE - CONTRACT - RFP - P821 FORMS SOFTWARE (2)Client#: 12366
OPTISOF
ACORa, CERTIFICATE
OF LIABILITY
INSURANCE
062402°°""'
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Hamilton Dorsey Alston Company
4401 Northside Pk Suite 400
wY
ONLY
HOLDER.
ALTER
AND CONFERS NO RIGHTS UPON THE CERTIFICATE
THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Atlanta, GA 30327-3078
770 850-0050
INSURERS AFFORDING COVERAGE
INSURED
Optio Software, Inc.
3015 Windward Parkway
Windward Fairway 11
Alpharetta, GA 30005
INSURER A:
Hartford Insurance Company
INSURER 8:
INSURER C:
— " - 840
li INSURER D:
INSURERE:
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
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE M/DDr1Y
POLICY EXPIRATION
DATE M D/YY
LIMITS
A
GENERALUABILITY
20UUNUX4610
04/03/02
04/03/03
EACH OCCURRENCE
$1 000000
FIRE DAMAGE(Any onefirs)
$300,000
X COM MERCIAL GENERAL LIABILITY
CLAIMS MADE [ill OCCUR
,
MED EXP (Any one person)
1$10,000
PERSONAL S ADV INJURY
$1 OOO OOO
GENERAL AGGREGATE
$1 OOO OOO
GEN'L AGGREGATE LIMITAPPLIES PER:
PRODUCTS -COMP/OP AGO
$1 OQO OOO
PRo- X]LOC
POLICY F I
A
AUTOMOBILELIABILITY
ANY AUTO
2000NUX4610
04/03/02
04/03/03
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
ALL OWNED AUTOS
BODILY INJURY
SCHEDULED AUTOS
I
erper
(Per person)
$
X
BODILY INJURY
(Peraccident)
'$
HIREDAUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE
(Per aocitlen
$
i
GARAGE LIABILITY
!
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTOONLV: AGO
$
ANY AUTO
r---
----
$
A
EXCESS LIABIUTY
20XHUUX4701
04/03/02
04/03/03
EACH OCCURRENCE
$10000000
DX OCCUR 1:1 CLAIMS MADE
AGGREGATE
$1 0 OOQQ, OOO_._
_
is
n_ DEDUCTIBLE
$
X RETENTION $$1 O 000
A
WORKERS COMPENSATION AND
20WBGD6841
04/03/02
04/03/03
CETATU- OTH-
IWTOR
EMPLOYERS'LIABILITY
E.L. EACH ACCIDENT
$500,000
MPLOY
E.L. DISEASE -EA EEE
$SOO,000
E.L. DISEASE - POLICY LIMIT
$SO6,000
A
DTMER Property
2000NUX4610
04/03/02
04/03/03
$1,851,000 PP/EDP
$1,000 Deductible / RC
Special Form
DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Certificate Holder is Included as Additional Insured as respects General Liability Coverage, but only for work
performed by or on behalf of the Named Insured.
DESCRIBED POLICIESBE CANCELLED BEFORE TH E EXPIRATION
City of Ft. Collins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30—DAYSWRITTEN
Attn: James B. O'nelll NOTICE TOTHE CERTIFICATE HOLDER NAM ED TOTHE LEFT, BUT FAILURE TO DO SO SHALL
215 North Mason Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURERJTS AGENTS OR
2nd Floor;P.O. BOX 580 REPRESENTATIVES.
Fort Collins, CO 80522 AUTHORIZED REPRES TATIVE
For RDA By: III,I it A 0 V]X f
25-S (71971 H of 9 0g11GnAr1U4 A4RA9 PUW n ACORD CORPORATION 19RR
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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.
AcoRo25-5pn97f2 of 2 #S139065/M133867