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Home My WebLink AboutOPTIO SOFTWARE - INSURANCE CERTIFICATE (4)ACORD,. CERTIFICATE OF LIABILITY INSURANCE YVYV) 0DATE 4l05l4105/ 5 05 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Wachovia Insurance Serv-AT, GA ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4401 Northside Pkwy, Suite 400 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Atlanta, GA 30327-3078 770 850-0050 INSURERS AFFORDING COVERAGE NAIC # INSURED Hartford Fire Insurance Company 19682 OptINSURERA: Software, Inc. INSURER B. Hartford Casualty Insurance Company 29424 3015 015 Windward Parkway INSURERC: Twin City Fire Insurance Company 29459 Windward Fairways II Alpharetta, GA 30005 INSURER D:INSURER E: GU V CK;AULb 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD POLICY EXPIRATION DATE MMIDD/YY LIMITS A GENERAL LIABILITY 2000NUX4610 04/03/05 04/03/06 EACH OCCURRENCE $1 00D 000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FX OCCUR DAMAGE TO RENTED PREMISE (Ea _o=urrencO $3OO DUD MED EXP (Any one person) $1 D 000 PERSONAL & ADV INJURY $1 000 000 GENERAL AGGREGATE $1 000,000 GEN'L AGGREGATE LIMITAPPLIES PER: PRODUCTS-COMP/OP AGG $1000000 POLICY PRO JECT LOC A AUTOMOBILE LIABILITY ANY AUTO 2000NUX4610 04/03/05 04/03/06 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Peraccident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG B EXCESS/UMBRELLA LIABILITY X1 OCCUR CLAIMS MADE 20RHUUX5493 04/03/05 04/03/06 EACH OCCURRENCE $10 000 000 AGGREGATE $10 000 000 $ DEDUCTIBLE X RETENTION $ 1 U 000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 20WBGD6841 04/03/05 04/03/06 )( WC STATU- I OTH- E.L. EACH ACCIDENT $500000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? If yes, describe under E.L. DISEASE - EA EMPLOYEE $500,000 E.L. DISEASE - POLICY LIMIT $500,UDD SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate Holder is included as Additional Insured as respects General Liability Coverage, but only for work performed by or on behalf of the Named Insured. City of Ft. Collins Attn: James B. O'neill 215 North Mason Street 2nd Floor;P.O. Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL -'A0_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED REPRESEN TIV For wISby: /d ---- %�-wuvv/ T OT z iF56Lz/z11Mtizz797 DLS01 0 ACORD 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. --^------�••�� c yrc PP.70221Z1/M0L1rlr