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Home My WebLink AboutCORRESPONDENCE - RFP - P916 GIS RELATED APPLICATION DEVELOPMENTAGORA, CERTIFICATE IF LIABILITY INSURANCr- DATE(MIWDDNYYY) O1/22/2004 THIS CERTIFICATE IS ISSUE, AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PRODUCER (305)822- 7800 FAX 3058[7OS85 Collinsworth, Alter, Fowler, Dowling & French Group Inc. P. O. Box 9315 Miami Lakes, FL 33014-931S INSURERS AFFORDING COVERAGE # TAV INSURED post, Buckley, Schuh, & Jernigan, Inc. d/b/a PBS&I 2001 NW 107 Avenue Miami, FL 33172-2SO7 SURERA Continental Casu INalty Company INSURERS American Casualty Co Reading A XV wsUHLHU Lloyds of London A- XV 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 D' TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTNE POLICYEXPIRATION LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR Contractual Liab GL247843206 09/30/2003 09/30/2004 EACH OCCURRENCE $ 1,000,000 X DAMAGE TO RENTED $ 1,000,0001 MED EXP (Arty one person) S 25,00 X PERSONAL &ADVINJURY $ 1,000,00 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLES PER: POLICY F—XPRODUCTS , PERT X LOC - COMPfOP qGG $ 2,000,000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS BUA247843223 09/30/2003 09/30/2004 COMBINED SINGLE LIMIT (Ea accident) $ 1' QQQ' DD X X BODILY INJURY (Per person) $ A SCHEDULED AUTOS HIRED AUTOS X NON -OWNED AUTOS BODILY INJURY (Per accident) $ X X Contractual Liab PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY- EA ACCIDENT $ ANYAUTO OTHER THAN EAACC AUTO ONLY AGG S $ A EXCESSAIMBRELLALWBILTIY X OCCUR CLAIMS MADE CUP2068179760 09/30/2003 09/30/2004 EACH OCCURRENCE S 10,000,000 AGGREGATE $ 1-0,00-0,0-10 $ DEDUCTIBLE X RETENTION $ 10,00C$ S WORKERS COMPENSATION AND WC247843268 09/30/2003 09/30/2004 EMPLOYERS' LIABILITY X T C ATUL ER B ANY PROPRIETORIPARTNERfEXECUTIVE OFFICERMIEMBER EXCLUDED? NO I s, 'a cribs under SPECIAL PROVISIONS below C Professional/Pollutio P42303 09/30/2003 09/30/2004 Liability CLAIMS -MADE FORM DESCRIPMON OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENTI SPECIAL PROVISIONS ^. MWIr1^AWrI-- E.L. EACH ACCIDENT $ 11000,000 E.L.DISEASE-EAEMPLOYEE $ 1,000,00 E.L. DISEASE - POUCY LIMIT S 1 QQQ QQ $1,000,000 Limits Ea Claim and Annual Aggregate 11/11/1961 Retrodate City of Fort Collins Attn: Katy Carpenter/City P.O.Box S80 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVORTOMAIL —DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Clerk BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY HIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. (Meade Coll insworth/EEC Xri%—A -TAW-j--Vt 1 ACORD 25 (2001/08) OACORD CORPORATION 1988 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. ACaRD CERTIFICATE IF LIABILITY INSURANC oijziz o THIS CERTIFICATE IS ISSUhw AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PRODUCER (30S)822-7800 FAX 3058c7058 S Collinsworth, Alter, Fowler, Dowling & French Group Inc. P. 0. Box 9315 Miami Lakes, FL 33014-9315 INSURERS AFFORDING NAIC# INSURED Post, Buckley, Schuh, & Jernigan, Inc. d/b/a PBS&J 2001 NW 107 Avenue Miami, FL 33172-2507 rnvrewnri. INSURERA: Continenity Company A V INSURERS: American Co Reading A V NSURERC Lloyds oA- XV 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 BYTHE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR D' TYPE OF INSURANCE POLICY EFFECTIVE POLICY E%PIRATION POLICY NUMBERDATE IMM)DDNY) LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMSMADE � OCCUR Contractual LTab GL247843206 09/30/2003 09/30/2004 EACHOCCURRENCE $ 1,000,00 X DAMAGE TO RENTED MEDEXP(AN onepemon) $ 1,000 00 $ 25,00 X PERSONAL &ADV INJURY $ 11000,00( GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X JECOT X LOC PRODUCTS -COMPIOP AGG $ 2,000,00( AUTOMOBILE X LIABILITY ANYAUTO ALL OWNED AUTOS BUA247843223 09/30/2003 09/30/2004 COMBINED SINGLE LIMB (Ea accident) $ 1,000,000 X BODILY INJURY IPerpersan) $ SCHEDULED AUA -CS HIRED AUTOS X NON -OWNED AUTOS BODILYNJURY (Per accident) $ X X Contractual Liab PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY -EAACCIDENT $ ANY AUTO OTHER THAN EA ACC AUTO ONLY. AGG $ $ A E%CESSIUMBRELLALIABILITY X OCCUR CLAIMS MADE CUP2068179760 09/30/2003 09/30/2004 EACH OCCURRENCE $ 10,000,00 AGGREGATE $ 10 000 OO $ RDEDUCTIBLE X RETENTION $ 10,000 $ $ WORKERS COMPENSATION AND WC247843268 09/30/2003 09/30/2004 EMPLOYERS' LABILITY X I WCSTATLL O H- TORY LIMITS ER B ANY PROPRIETORIPARTNERrEXECUTIVE OFFICEPMEMBER EXCLUDED? NO Il yes,'a cnbe under SPECIAL PROV510NS below C Professional/Pollutio P42333 09/30/2003 09/30/2004 Liability CLAIMS -MADE FORM 1 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENTI SPECIAL PROVISIONS nGOTICInwTr..�. r.r.. E L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEE $ 1,000,00C E.L. DISEASE -POLICY LIMB $ 1,000,00C $1,000,000 Limits Ea Claim and Annual Aggregate 11/11/1961 Retrodate SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL City of Fort Collins 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Attn: Katy Carpenter/City Clerk BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY P.O. Box 580 OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. Fort Collins, CO 8OS22 AUTHORUEDREPRESENTATIVE py f Meade Coll insworth/FFC ACORD 25 (2001/08) OACORD CORPORATION 1988 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.