HomeMy WebLinkAboutCORRESPONDENCE - GENERAL CORRESPONDENCE - 2004 INSURANCE CERTIFICATE (2)ACORM CERTIFICATE OF LIABILITY INSURANCE o„26/04°""'
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
Denver, CO 80203 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
303 837-8500 INSURERS AFFORDING COVERAGE
INSURED CTL/Thompson, Inc. INSURER A: Hartford Insurance Group
— - - -- ---
INSURER B: Pinnacol Assurance
1971 West 12th Avenue INSURER C: Lexington Insurance Company (AIG)
Denver, CO 80204 INSURER D:
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 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 EFFECTIVE
POLICY NUMBER DATE MM/DDNY
POLICY EXPIRATION
DATE MM/DnIVY LIMITS
A
GENERAL LIABILITY
34UUNEX2070
10/01/03
10/01/04
EACH OCCURRENCE
$1000,000
X COMMERCIAL GENERAL LIABILITY
ICLAIMS MADE x OCCUR
FIRE DAMAGE (Any one tire)
$300000
MED EXP (Any one person)
$1 Q QQQ
PERSONAL & ADV INJURY
1 $1,000,QQQ
X PD D@d:1,000
GENERALAGGREGATE
'$2,000,000
GEN'L AGGREGATE LIM ITAPPLIES PER:
-� POLICY X PRO- LOC
JECT
PRODUCTS-COMPIOPAGG
s2,000,000
-- - -
A
AUTO
MOBILE LIABILITY
ANY AUTO
'34UENEX2190
10/01/03
10/01/04
,COMBINED SINGLE LIMIT
(Ea accident)
$1,000,OQO
X
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per person)
$
X
HIRED AUTOS
NON -OWNED AUTOS
BODILY INJURY
(Per accident)
$
X
Drive Other Car
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
-_-
$
AUTO ONLY: AGO
A EXCESS LIABILITY
X OCCUR CLAIMS MADE
34XHUEX1980
10/01/03
10/01/04
EACH OCCURRENCE
$2,000,000
_
AGGREGATE
$2,000,000
DEDUCTIBLE
$
XRETENTION $10000 1
$
B
'
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
618052
10/01/03
10/01/04
X WC STIMIT OTH-
T RY LIMIT ER
E.L_EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
--.
$500,000
$500,000
E.L. DISEASE - POLICY LIMIT
$500,000
C
OTHER Architects &
Engineers
Professional Liab
5397819
11/22/03 11/22/047$2,000,000
per claim
000,000 annl aggr.
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES!EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
City of Ft. Collins, Purchasing Division is listed as an Additional Insured,
under General Liability only, in respects to their interest in work performed
by the insured as per written specified contracts.
City of Ft. Collins
Purchasing Division
P.O. Box 580
Fort Collins, CO 80522
SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL An DAYSWRITTEN
NOTICETOTHE CERTIFICATE HOLDER NAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL
IMPOSE NO OB LIGATION OR LIABILITY OF ANY KIND UPON TH E INSU RE R,ITS AGENTS OR
REPRESENTATIVE
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