HomeMy WebLinkAbout310036 BLUE DOT SOLUTIONS INC - INSURANCE CERTIFICATE (11)TE
ACORD. CERTIFICATE OF LIABILITY INSURANCE UODC06-11 2004
PRODUCER 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 INSURERA:Hartford Fire Ins Co
INSURER B:
BLUE DOT SOLUTIONS, INC INSURER C:
602 PARK POINTS DR. #255 INSURER D:
GOLDEN CO 80401 INSURER E:
rnvFRanFc
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
LTR
TypE OF INSURANCE
POLICY NUMBER
PoLN:Y EFFECTIVE POLICY EXPIRATION LIMITS
DATE MMIDD/YY DATE MMIDD/YY
GENERAL LIABUJ Y
EACH OCCURRENCE 1 $1, 0 0 O 0 0 0
A
COMMERCIAL GENERAL LIABILITY
34 SBA FP 3 8 0 9
0 7/ 0 9/ 04
0 7/ 0 9/ 0 5 1 FIRE DAMAGE (Any one fire) is3OO, 000
CLAIMS MADE l X l OCCUR
MED EXP (Any one person) $10 , 000
X Business Liab
PERSONAL &ADV INJURY $1, 000, 000
GENERAL AGGREGATE s2,000,000
PRODUCTS - COMP/OP AGG s2,000,000
GEWL AGGREGATE LIMIT APPLIES PER:
POLICY PRO X LOC
JECT
AUTOMOBILE
UABRJTY
COMBINED SINGLE LIMIT
$
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 LIABILffY
AUTO ONLY - EA ACCIDENT
$
$
ANY AUTO
OTHER THAN EA ACC
$
AUTO ONLY: AGG
EXCESS LIABILITY
EACH OCCURRENCE $
_
OCCUR a CLAIMS MADE
AGGREGATE $
S
DEDUCTIBLE
I $
RETENTION S
$
WORKERS COMPENSATION AND
WC STATUDRY LIM - I OTH-
ER
EMPLOYERS' IUABUM
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATNINSAACATIONSIVEHR:LESIEXCLUSN)NS ADDED BY ENDORSEMENVSPECIAL PROVISIONS
Those usual to the Insured's Operations.
CERTIFICATE HOLDER ( X I ADDITIONAL INSURED; INSURER LETTER: A CANCELLATION
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 SO SHALL IMPOSE NO
PO BOX 580
OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
Fort Collins CO 80522
AUTHORIZED REPRESENT(��('E
mounv cD-a Iinp11 0 ACORD CORPORATION 1988