HomeMy WebLinkAboutTELESUPPORT SERVICES INC - INSURANCE CERTIFICATEAWMn CERTIFICATE OF LIABILITY INSURANCE 09/14/2004 DATE(MWDM-YYY)
PRODUCER (303 442
-1484 FAX k303)442-8822 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Taggart & Associates, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1600 Canyon Boulevard HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P. 0. Box 147 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Boulder, CO 80306 INSURERS AFFORDING COVERAGE NAIC #
INSURED TELESUPPORT SERVICES INC INSURERA: Phoenix 25623
4830 PEARL ST INSURERB: Travelers Insurance Group
BOULDER, CO 80301 INSURERC: Pinnacol Assurance 41190
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.
II T R
D'
TYPE OF INSURANCE
POLICY NUMBER
POL_DAICY EFFECTWE
OS/23/2004
POLICY EXPIRATION
LIMITS
A
GENERAL LIA UTY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE a OCCUR
I6807768W116PHX04
05/23/2005
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTEDanca�
$ 300 OO 01
$ 5 00
MED EXP (Any one person)
PERSONAL & ADV INJURY
$ 1,000,00(
GENERAL AGGREGATE
$ 2,000,00(
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY PRO-
JECT F1 LOC
PRODUCTS-COMP/OP AGG
$ 2,000,00(
AUTOMOBILE
LIABILITY
ANYAUTO
I6807768W116PHX04
05/23/2004
OS/23/2005
COMBINED SINGLE LIMIT
(Ea accident)
$ 1100010013
ALL OWNED AUTOS
A
SCHEDULED AUTOS
HIREDAUTOS
BODILY INJURY
(Per person)
f
X
NON-OWNEDAUTOS
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Par accident)
a
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
1
OTHER THAN EA ACC
E
AUTO ONLY: AGG
$
B
EXCESS/UMBRELLALIA&LITY I
X OCCUR CLAIMS MADE
F CUP 7768W221-IND-03
05/23/2004
05/23/2005
EACH OCCURRENCE
$ 1,000 00
AGGREGATE
$ 11000,000
a
DEDUCTIBLE
X RETENTION $ 5 , 00
$
$
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
34S40SS
10/01/2004
10/01/2005
I WC STATU- I oTH-
FR
E.L. EACH ACCIDENT
$ 100 00
C
ANY PROPRIETOR/PARTNER/EXECUTNE
OFFICER/MEMBER EXCLUDED?
Des describe under
SPECIAL PROVISIONS below
OTHER -T
E.L. DISEASE - EA EMPLOYE
$ ZOO OO
E.L. DISEASE - POLICY LIMIT $ SOD 0O
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES f EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
e: Bid #5757 Cabling - Fiber Optic & Copper
City of Fort Collins
Attention: Ed Bonnette, C.P.M.
Purchasing Division
215 North Mason Street
2nd Floor
Fort Collins, CO 80S22
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE _
Michael Taggart CPCU CIC/L:/Oyy,�
Mwmw zu %AwV I/Vol -rye-
®ACORD CORPORATION 1988