HomeMy WebLinkAbout112468 FELSBURG HOLT & ULLEVIG INC - INSURANCE CERTIFICATE (16)ACORD. CERTIFICATE OF LIABILITY INSURANCE 06/28104°°ACORD.
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Van Gilder Insurance Corp. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
700 Broadway, Suite 1000 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Denver, CO 80203 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
303 837-8500 INSURERS AFFORDING COVERAGE
INSURED
Felsburg Holt & Ullevig, Inc.
6300 S. Syracuse Way, #600
Centennial, CO 80111
INSURERA:St. Paul Insurance (Med/A&E)
INSURER B:Hartford Insurance Group
INSURERc:Hartford Insurance (Service Center)
INSURER D:XL Specialty Insurance Company
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
LTRT
TYPE OF INSURANCE
POLICYNUMBER
POLICYEFFECTIVE
M/DD/
POLICY EXPIRATIONS
/YYI
- --
LIMITS
A
GENERAL LIABILITY
BKO1421523
05/01/04
05/01/05
EACH OCCURRENCE
$1,000,000
X COMMERCIAL GENERAL LIABILITY
1 CLAIMS MADE OCCUR
FIRE DAMAGE (Any one fire:
$1,000,000
MED EXP(Anyone person)
PERSONAL BADV INJURY
_$10,000
$1 000 000
GENERAL AGGREGATE
$2 D00,000
GENL AGGREGATE LIMIT APPLIES PER:
IJP PRO- n LOC
PRODUCTS-COMP/OP AGO
$2 000 000
B
AUTOMOBILE
X
LIABILITY
ANY AUTO
34UECFW5245
05/01/04
05/01/05
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
X
X
NON-OWNEDAUTOS
BODILY INJURY
(Per accident)
$
—
PROPERTY DAMAGE
(Peraccident)
$
OAR AGE LIABILITY
AUTO ONLY -EA ACCIDENT
$
OTHER THAN EA AC
AUTO ONLY: AGO
ANY AUTO
$
A
EXCESS LIABILITY
X OCCUR CLAIMS MADE
BKO1421523
05/01/04
05/01/05
EACH OCCURRENCE
$4 000 000
AGGREGATE _
$4 000,000
a
DEDUCTIBLE
X RETENTION $
Is
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
34WEGKC2800
05/01/04
05/01/05
X WC STATU- 0 H-
E.L. EACH ACCIDENT
$500,000
E.L.DISEASE-EA EMPLOYEE
$500,000
E.L. DISEASE -POLICY LIMIT
$500,000
D
(OTHER Architects &
DPR9401794
06/21/04
06121/05
$2,000,000 per claim
Engineers
$4,000,000 annl aggr.
rofessional Liab
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE: #P-768 North College Corridor Improvements Phase I
CERTIFICATE HOLDER ADDITONAL1NSURED•INSURER LETTER: CANCELLATION
SHOULD ANY OFTHE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION
City of Fort Collins
DATE THEREOF,THE ISSUING INSURER WILL EN DEAVORTO MAI L30—_DAYSWRITTEN
Administrative Services -Purchasing
NOTICETOTHE CERTIFICATE HOLDER NAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL
215 N Marson St.,2nd Floor
IMPOSE NO OBLIGATION OR LIABILITY OFANYKIND UPON THE INSURER,ITS AGENTS OR
PO Box 580
REPRESENTATIVES.
Fort Collins, CO 80522-0580
AUTHO IZED REPRESENTATIVE
ACORD LD-S (//9/)1 of 1 #M367652 ' MQG 0 ACORD CORPORATION 1988