HomeMy WebLinkAboutCORRESPONDENCE - GENERAL CORRESPONDENCE - INSURANCE CERTIFICATE (2)ACORD. CERTIFICATE OF LIABILITY INSURANCE 01/07/04°""'
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Van Gilder Insurance Corp. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
700 Broadway, Suite 1000 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver, CO 80203
303 837-8500 INSURERS AFFORDING COVERAGE
INSURED INSURER A: Hartford Insurance (Service Center)
e Engineering Company INSURER B. Indian Harbor Insurance
2310 E. Prospect, Suite B
INSURER C:
Fort Collins, CO 80525 - -
INSURER D:
INSURER E:
r8r*194 TTVT*_9
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 MM/DD/YY
POLICY EXPIRATION
DATE MWDD/YY
LIMITS
GENERAL LIABILITY
COMM ERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
EACH OCCURRENCE
$
FIRE DAMAGE (Any one fire)
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
_._
GEN'L AGGREGATE LIM IT APPLIES PER:
POLICY PRO- LOC
PRODUCTS -COMP/OPAGG
$
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
�.
COMBINED SINGLE LIMIT
(Ea accident)
$
$
BODILY INJURY
(Per person)
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
-
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT $
OTHER THAN EA ACC $
AUTOONLY: AGG $
_EXCESS LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
$
AGGREGATE
$
'$
A
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
34WEGKE5019
01/01/04 01/01/05
X WC STATU- OTH-
T CRY IMIT ER
_—------"--- --
$1,000,000
$1,000,000
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE -POLICY LIMIT
$1,000.000
B OTHER Professional
Liability
DPI9421010
12/12/03 12/12/04
$1,000,000 per claim
$2,000,000 annl aggr.
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
LLI ICN:
City of Fort Collins
Attn: James B. O'Neill II
P.O. Box 580
Fort Collins, CO 80522
SHOULD ANYOFTH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30_-DAYS WRITTEN
NOTICE TOTHE CERTIFICATE HOLDER NAMED TOTHE LEFT, BUT FAILURE TO DO SOSHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR