HomeMy WebLinkAbout109315 COLORADO DOORWAYS INC - INSURANCE CERTIFICATE (15)ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID DATE(MMIOD/YYYY)
COLOROI 08 28 03
PRODUCER
Thomas J. Sisk & Company, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Mile High Center HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1700 Broadway, Suite 1000 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver CO 80290
Phone: 303-831-7100 Fax: 303-831-7377 INSURERS AFFORDING COVERAGE NAIC #
INSURED
INSURERA: Hartford Fire Insurance Co.
Colorado Doorways Inc. INSURERB: Pinnacol Assurance
Doorway Solutions INSURER C:
52nd & Cook LLP
3333 E 52nd Ave INSURER D:
Denver CO 80216
INSURER E:
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
INSRK
TYPE OF INSURANCE
POLICY NUMBER
DATE (MMIDD/YY)
DATE (MM/DDlYY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
X COMMERCIALGENERAL LIABILITY
CLAIMS MADE FX] OCCUR
34UUNTZ1983
09/01/03
09/01/04
DAMA(3r: TO RENTED
PREMISES (Ea occurence)
$300,000
MED EXP (Any one person)
$ 10 , 000
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2 , 000 , 000
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY JEST LOC
PRODUCTS - COMP/OP AGG
$ 2 , 000 , 00 0
A
AUTOMOBILE
LIABILITY
ANY AUTO
34UUNTZ1983
09/01/03
09/01/04
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
M
OTHER THAN EA ACC
AUTO ONLY: qGG
$
$
A
EXCESSlUMBRELLA LIABILITY
X OCCUR ❑ CLAIMSMADE
34XHUTZ2002
09/01/03
09/01/04
EACH OCCURRENCE
$ 4 , 000 , 000
AGGREGATE
$ 4, 000, 000
DEDUCTIBLE
$
X RETENTION $ 10 000
$
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED?
It yes,descnbeunder
SPECIAL PROVISIONS below
3142569
09/01/03
09/01/04
X TORY LIMITS ER
E.L. EACH ACCIDENT
$500,0 00
E.L. DISEASE -EA EMPLOYEE
$ ,
500 000
E.L. DISEASE -POLICY LIMIT
$500 000
A
Equipment Floater
34UUNTZ1983
09/01/03
09/01/04
Limit $86,848
Deductibl $500
The City, its officers, agents and employees are named as additional
insureds but only as respects work performed by the named insure.
Cancellation: The insurance evidenced by this certificate will not be
cancelled or materially altered except after ten (10) days written notice
has been received by the City of Fort Collins.
r9=0TlciceTo unl nco .....__.. -_._-.
City of Fort Collins
Attn: John Stephen
PO Box 580
Fort Collins CO 80522
CITYOFF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL BISMAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT 5AWD8M0000=SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID 1 1 DATE(MM/DD/YYYY) I
COLOR01 08/28/03
Thomas J. Sisk & Company, Inc.
Mile High Center
1700 Broadway, Suite 1000
Denver CO 80290
Phone:303-831-7100 Fax:303-831-7377
Colorado Doorways Inc.
Doorway Solutions
52nd & Cook LLP
3333 E 52nd Ave
Denver CO 80216
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 I NAIC #
INSURERA: Hartford Fire Insurance Co.
INSURERS: Plnnacol Assurance
INSURER C:
INSURER D:
INSURER E:
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
VE
DATE (MMFEMI)
rlD YY)
DATE (M
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE � OCCUR
34UUNTZ1983
09/01/03
09/01/04
EACH OCCURRENCE
$ 1 , 000 , 000
DAWMO RE 4-
PREMISEES(Ea occ rence)
$ 300 000
MED EXP (Any am person)
$ 10 , 000
PERSONAL &ADV INJURY
$ 1 , 000 , 000
GENERAL AGGREGATE
$ 2 , 000 , 000
GEN'L AGGREGATE LIMIT APPLIES PER:
j[ POLICY jEC0j LOC
PRODUCTS - COMP/OP AGG
$ 2 , 000 , 000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
34UUNTZ1983
09/01/03
09/01/04
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
A
EXCESS/UMBRELLA LIABILITY
X OCCUR F-1CLAIMSMADE
DEDUCTIBLE
j[ RETENTION $ 10 000
34XHUTZ2002
09/01/03
09/01/04
EACH OCCURRENCE
$ Q 000 , 000
AGGREGATE
$4,000,000
$
$
B
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
describe under
DSPECIAL PROVISIONS below
3142569
09/01/03
09/01/04
X TORY LIMITS I ER
E.L. EACH ACCIDENT
$500/ 000
E.L. DISEASE - EA EMPLOYEE
$ 5 0 0, 0 0 0
E.L. DISEASE -POLICY LIMIT
$500 000
A
Equipment Floater
34UUNTZ1983
09/01/03
09/01/04
Limit $86,848
Deductibl $500
I.CK I IrM A 1 C 17ULUCK k AK1..CLLA I IUIY
CITYOFF
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
City of Fort Collins
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR
Attn: James B. O'Neill II CPPO
PO BOX 580
REPRESENTATIVES.
Fort Collins CO -
Thomas J. Sisk Jr.