HomeMy WebLinkAbout310036 BLUE DOT SOLUTIONS INC - INSURANCE CERTIFICATE (10)ACORD „ CERTIFICATE OF LIABILITY INSURANCE DATE
05-10-2005
rx000t tit THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
COBIZ INSURANCE, INC/PHS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
340725 P: (866)467-8730 F: (877)905-0457 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P. 0. BOX 33015
SAN ANTONIO TX 78265 INSURERS AFFORDING COVERAGE
INSURED INSURER A: Hartford Fire Ins Co
INSURER B:
BLUE DOT SOLUTIONS, INC INSURER C:
602 PARK POINTS DR. #255 INSURER D:
GOLDEN CO 80401 INSURER E:
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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.
INSfl TYPE OF INSURANCE POLICY NUMBER
LTR
POLICY EFFECTNE
DATE MMM M'
POLICY EXPIRATION LIMBS
DATE MM/DD/YV
GENERAL LIABILITY
EACH OCCURRENCE $1, 0 0 0, 0 0 0
A
COMMERCIAL GENERAL LIABILITY
34 SBA FP3809
07/09/05
07/09/06 FIRE DAMAGE(Anyonelire) s300, 000
CLAIMS MADE u OCCUR
MED EXP (Any one person) $10 , 0 0 0
X Business Liab
PERSONAL &AOV INJURY $1, 000, 000
GENERAL AGGREGATE s2,000, 000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPfOP AGG s2,000,000
POLICY PROECT X LOC
J
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT 4
ANY AUTO
(Ea accident)
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS
(Per person)
HIRED AUTOS
BODILY INJURY $
NON -OWNED AUTOS
(Per accident)
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT $
ANY AUTO
OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY
EACH OCCURRENCE $
_
OCCUR a CLAIMS MADE
AGGREGATE $
$
$
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION AND
WC STATU- OTH-
TOY IMIT R
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONSILOCATKINSIVEHV:LESIEXCLUSKINS ADDED BY ENDORSEMENT(SPECIAL PROVISIONS
Those usual to the Insured's Operations.
L.CR I imos%IC 11ULIJCN I A AOORIONAL INSURED; INSURER LETTER: M. C;AIYVCLLAI IUM
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 45 DAYS WRITTEN NOTICE (10 DAYS FOR NON-PAYMENT) TO THE CERTIFICATE
Attn : Jim Hume HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO $0 SHALL IMPOSE NO
PO BOX 580
OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTFort Collins CO 80522
ACORD zs-S 17197) 0 ACORD CORPORATION 1988