HomeMy WebLinkAboutCORRESPONDENCE - GENERAL CORRESPONDENCE - INSURANCE CERTIFICATE (2)ACORD CERTIFICATE OF LIABILITY INSURANCE CSR RM DATE(MMMONYYY)
ROTHB-1 09 10 03
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
ACEC/MARSH HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
800 Market St, Ste. 2600 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
St. Louis M0 63101-2500
Phone: 800-338-1391 Fax: 888-621-3173 INSURERS AFFORDING COVERAGE NAIC 9
INSURED INSURER A: Hartford Insurance Company_22357
Rothberg Tamburini & Winsor, INSURER B:
Inc;RTW Professional Engineers _- _ _-- -- ----
S Consultants` Inc. INSURER C
6:
1576 Sherman treet #100 INSURER D:
Denver CO 80203 --- -- — - -
INSURER E:
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.
INSLTR
HER
TYPE OF INSURANCE
POLICY NUMBER
DAM(MMIFDDm
PDAEYMMPDDTY)
LIMITS
GENERAL UABIUTV
EACH OCCURRENCE
$ 1 OOO O )0
A
X COMMERCIAL GENERAL LIABILITY
84SBXCG4297
11/01/03
11/01/04
$300,000
PREMISES aa.u.ronce�
1 CLAIMS MADE FXOCCUR
r
MED UP(Any one person)
_
$lO Q
PERSONAL B ADV INJURY
$1,000 000
GENERAL AGGREGATE
s2,000,000
_
PRODUCTS-COMP/OP AGG
$2,000 000
rGEN`GEFTAGGREGATE LIMIT APPLIES PER: L AGG
POLICY X �0 7 LOC
AUTOMOBILE
LIABILITY
!
COMBINED SINGLE LIMB $ 1 000, 000
A
X
ANY Auro
84UEGNP2051 11/01/03
11/01/04
(Ea accident) r
BODILY INJURY
ALL OWNED AUTOS
SCHEDULED AUTOS
(Per person) ',$
HIRED AUTOS
BODILY INJURY
$
NON -OWNED AUTOS
(Per accident)
----
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN _EA ACC
ANY AUTO
I
�$
AUTO ONLY: AGG
$
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$ 1, 000 000
A__OCCUR
CLAIMS MADE
84SEXCG4297
11/01/03 11/01/04
AGGREGATE
,
$1,000,000-
-_..
IF_
$
DEDUCTIBLE
$
RETENTION $
$
WORKERS COMPENSATION AND
1TORY LIMITWG S.J_ ER
EMPLOYERS' LIABILITY
E L EACH ACCIDENT
ANY PROPRIETORIPARTNERIEXECUTIVE
$
E.L. DISEASE - EA EMPLOYEE.
$
OFFICER/MEMBER EXCLUDED?
1 ltyes, describe under
---- ------
-------
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
! $
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
CTYFTCO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOs
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
CITY OF FT. COLLINS NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
ATTN: OPAL DICK IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
PO BOX 580 REPRESENTATIVES.
FT. COLLINS CO 80522-0580 AUTHORIZEDRWfjENTA_jpVEr\
O ACORD