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HomeMy WebLinkAboutPOST BUCKLEY SCHUH JERNIGAN PBS J - INSURANCE CERTIFICATE (5)ACORD,M CERTIFICATE OF LIABILITY INSURANCE 10/02/z a) PRODU' ER (305)822-7800 FAX 3058270585 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Collinsworth, Alter, Fowler, Dowling ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE & French Group OLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR p Inc.. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. 0. Box 9315 Miami Lakes, FL 33014-931S INSURERS AFFORDING COVERAGE NAIC # INSURED Post, Buckley, Schuh, & Jernigan, Inc. INSURERA: Sentry Insurance a Mutual Compan A+ XV d/b/a PBS&J INSURERS: Steadfast Insurance Company A XV 2001 NW 107 Avenue INSURERC: Lloyds of London A XV Miami, FL 33172-2S07 INSURER D: 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. INSR OkDUL him TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATIONlift- LIMITS GENERAL LIABILITY 90-15807-03 09/30/2004 09/30/2005 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR DAMAGE TO RENTED $ 1,000,000 MED EXP (Any one person) $ 25,00( A X Contractual LT ab PERSONAL & ADV INJURY $ 1,000,00( GENERAL AGGREGATE $ 2,000,00( GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00( RO POLICY X ECT T LOC AUTOMOBILE LIABILITY ANY AUTO 90-1S807-04 90-1S807-05 09/30/2004 09/30/2005 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X X BODILY INJURY (Per person) $ A ALLOWNEDAUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X BODILY INJURY (Per accident) $ X Contractual Liab X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY X OCCUR CLAIMS MADE AUCS08762100 09/30/2004 09/30/200S EACH OCCURRENCE $ 25,000 00 AGGREGATE $ 2S,000,000 B $ DEDUCTIBLE X RETENTION $ 10,0D $ WORKERS COMPENSATION AND 90-15807-01 09/30/2004 09/30/2005 X I WC STATU- OTH- Y LIMITS ER EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? yes, describe under S SPECIAL PROVISIONS below 90-15807-02 NO E.L.A EA EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,00 roessional/ P42304 09/30/2004 09/30/2005 $1,000,000 Limits C ollution Liability Ea Claim and Annual Aggregate CLAIMS -MADE FORM 11/11/1961 Retrodate DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Fort Collins, City of Attn: Katy Carpenter/City Clerk P.O.Box 580 Fort Collins, CO 8OS22 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 Meade Collinsworth/EEC�ir AL:UKU ZO (ZUU9/UB) ©ACORD CORPORATION 1988