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ARCHITECTURAL ENERGY CORPORATION - INSURANCE CERTIFICATE (3)
- QC RQ CERTIFICATE OF LIABILITY INSURANCE 07/21//2 PRODUCER (303)442-1484 FAX (303)442-8822 Taggart & Associates, Inc. 1600 Canyon Boulevard P. 0. Box 147 Boulder, CO 80306 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED ARCHITECTURAL ENERGY CORPORATION 2540 FRONTIER AVENUE #201 BOULDER, CO 80301 INSURER Hartford Casualty Insurance Co 29424 INSURER Pinnacol Assurance 0000 INSURER INSURER D: INSURER E. I —I 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 ADD TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTIVE DATE IMMi POLICY EXPIRATIONLTR DATE MMIDDNYI LIMBS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE N OCCUR 34SBADUS290 09/01/2003 09/01/2004 EACHOCCURRENCE $ 1,000,000 DAMAGE TO RENTED nre $ 300,000 MED EXP (Arty one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. POLICY PE0. LOC PRODUCTS - COMP/OP AGG $ 2,000,000 AUTOMOBILE LIABILITY ANYAUTO 34SBADUS290 09/01/2003 09/01/2004 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ A ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X BODILY INJURY (Per accident) $ 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 34SBADUS290 09/01/2003 09/01/2004 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ 1,000,000 A $ DEDUCTIBLE X RETENTION $ 10,000$ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 4051631 01/01/2004 01/04/2005 X I ORYLIMI S OER E L. EACH ACCIDENT $ 1,000,000 B ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? It yes, describe under SPECIAL PROVISIONS below E L. DISEASE- EA EMPLOYEE $ 1,000,000 E L DISEASE- POLICY LIMIT $ 1 OUD DO OTHER -T DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS e: CSU Phase II / PO4-142 City of Fort Collins Purchasing Division Attn: James B. O'Neill II 21S North Mason Street 2nd Flo PO Box 580 Fort Collins , CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING IN SURER WILL ENDEAVOR TO MAIL 10 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 Douglas Bollman CIC ARM/LJIVJ tf Al.vrcUYOi[YUUTIUtl) Inn: w1U/[[1—OjUj ©ACORDCORPORATION 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. Al. V K U Zo l zuul lute)