HomeMy WebLinkAboutALLER LINGLE AND LYMAN DAVIDSON DOOLEY - INSURANCE CERTIFICATEFrom: Beth Jones At: Jim Anderson & Co. FaxID: 770-339-2062 To: Lyman Davidson Dooley, Inc.
Date: 5/9/05 09:25 AM Page: 2 of 2
acoRQ CERTIFICATE OF LIABILITY INSURANCE, CSR oB DATE (MM/9/1 Y)
YMAN-2 O5/09/OS
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
A & E ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Jim Anderson & Co. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
121 Langley Dr ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Lawrenceville GA 30045
Phone:770-962-4111 Fax:770-339-2062 INSURERS AFFORDING COVERAGE
irvaurteu INSURER A: ASSURANCE COMPANY OF AMERICA
INSURER B'. ST. PAUL GUARDIAN INS CO
Ly44 John F. Kennedy isari"man Davidson Dooley Ina.
38y INSURERC XL SPECIALTY INSURANCE CO
Suite B INSURER D.
Fort Collins CO 80525
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.
INSK LTR
TYPE OF INSURANCE
POLICY NUMBER
DATE (MMIDDM')POLICY EFFECTIVE
DAFULTE (MM/DDM')IN
LIMBS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
X COMMERCIAL GENERAL LIABILITY
PPSO41181083
09/01/04
09/01/05
FIRE DAMAGE (Any one fire)
$1,000,000
CLAIMS MADE rx-1 OCCUR
MED EXP (Any one person)
$ 10 , 000
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGO
$ 2 , 000 , 000
POLICY PECT LOC
A
AUTOMOBILE
LIABILITY
ANY AUTO
PPSO41181083
09/01/04
09/01/05
(EaacmEDSINGLELIMIT
CO accident)
$ 1 000 000
r
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Peraccident)
$
HIRED AUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGO
$
ANY AUTO
$
EXCESS LIABILITY
EACH OCCURRENCE
$ 4,000,000
A
X OCCUR ❑CLAIMS MADE
PPSO41181083
09/01/04
09/01/05
AGGREGATE
$4,000,000
$
DEDUCTIBLE
$
RETENTION $
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
WVA2443865
05/01/04
05/01/05
X TORY LIMITS IF I ER
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE - EA EMPLOYEE
$500,000
E.L. DISEASE- POLICY LIMIT
$ 500 , 000
OTHER
C
Professional
DPR9403846
06/23/04
06/23/05
Ea. Claim $1,000,000
Liability
Aggregate $2,000,000
DESCRIPTION OF OPERATIONS&OCATIONSNEHICLESMXCLUSKM ADDED BY ENDORSEMENTISPEC1AL PROVISIONS
PROJECT: P-839 Architectural & Engineering Services at Operation Services
for the City of Fort Collins. FAX #970-221-6707
For Professional Liability, aggregate limit is total insurance available
for claims presented within policy perior for all operations of insured.
Limit will be reduced by payments of indemnity and/or expenses.
�uGRIIrILr/IIG RVLVGR j`I IIVIYNL IrviVRCVj IrviVRCrt LC11Crt: yI1R\rCL4.I"111VIY
CITYFTC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Fort Collins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
Attn : James B . O'Neill, 11 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 30 SHALL
P.O. BOX 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR
215 No. Mason St., 2nd. Floor
Fort Collins CO 80522-0580 REPRESENTATIVES.
D