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Home My WebLink About280698 NORTH STAR DESIGN INC - INSURANCE CERTIFICATE (15)ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE 08-02-2004 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION VAN GILDER AGCY CO/A&E PRGM/PHS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 343366 P: (866)467-8730 F: (877)905-0457 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. 0. BOX 33015 SAN ANTONIO TX 78265 INSURED NORTH STAR DESIGN, INC. 700 AUTOMATION DR, UNIT I rnvFNTer.Fs INSURERS AFFORDING COVERAGE INSURER A: The Hartford Ins INSURER 8: INSURER C: 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. INS" LS TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTNE POLICY EXPNUITION LIMA DATE MMIDD/YY DATE MM/DDIYY GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE U OCCUR EACH OCCURRENCE FIRE DAMAGE (Any one fire) MED EXP (Any one person) PERSONAL A ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG $ $ $ $ $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ' PHA LOC JE $ AUTOMOBRE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT Eaa ideml $ BODILY INJURY (Per Pawn) $ BODILY INJURY (Per wadem) $ PROPERTY DAMAGE (Per aomdem) $ GARAGE UABRM ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS LIABILITY OCCUR u CLAIMS MADE DEDUCTIBLE RETENTION $ I EACH OCCURRENCE $ AGGREGATE $ $ $ 8 A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY 34 WEG KDO139 09/01/04 09/01/05 X I WC STATUS OTH- E.L. EACH ACCIDENT $100 000 E.L. DISEASE - EA EMPLOYEE $10 0 , 0 0 0 E.L. DISEASE - POLICY LIMIT s500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHK:LESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Those usual to the Insured's Operations. CFRTIFICATF 14AN nFR 1 1 enmmuar manuFn. imanam r Fn &- CAMCFI 1 eTInM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of Fort Collins -Purchasing EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 45 DAYS WRITTEN NOTICE (10 DAYS FOR NON-PAYMENT) TO THE CERTIFICATE Attn : P.O. Jan BOX 580 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 REPRESENTATIVES. Fort Collins, CO 80522 AUTHORIZED REPRESENTA3nfE j� ACORD 25-S (7/97) 0 ACORD CORPORATION 1988 ACORD. CERTIFICATE OF LIABILITY INSURANCE °" 08-02-2004 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION VAN GILDER AGCY CO/A&E PRGM/PHS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 343366 P: (866)467-8730 F: (877)905-0457 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. O. BOX 33015 SAN ANTONIO TX 78265 INSURERS AFFORDING COVERAGE INSURED NORTH STAR DESIGN, INC. 700 AUTOMATION DR, UNIT I WINDSOR CO 80550 COVFRArZFS INSURER C: INSURER M 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. VR TYPE OF INSURANCE POLICY NUMBER POLIOY EFFECTIVE LTR DATE MMlDD/YY POLICY EXMRATION LlAllffB DATE MMIDD/YY GENERAL LIABRITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any one fire) $ CLAIMS MADE u OCCUR I MED EXP (Any ane person) I S PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY I I PROJECT LOC AUTOMOBILE LIAMILI Y COMBINED SINGLE LIMIT $ ANY AUTO fEa aeoidem) BODILY INJURY $ ALL OWNED AUTOS SCHEDULED AUTOS (Per person) BODILY INJURY $ HIRED AUTOS NON -OWNED AUTOS - (Per accident) PROPERTY DAMAGE $ (Per accidem) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT IIANY OTHER THAN EA ACC $ AUTO S AUTO ONLY: AGG EXCESS LIABILITY EACH OCCURRENCE $ _ OCCUR u CLAIMS MADE I AGGREGATE 5 S $ DEDUCTIBLE $ RETENTION S WORKERS COMPENSATION AND X WC STATU- OTH- ER A EMPLOYERS' LUUUUTY 34 WEG KD 013 9 0 9 / 01 / 04 0 9 / 01 / 0 5 E.L. EACH ACCIDENT $10 0 , 0 0 0 E.L. DISEASE - EA EMPLOYEE $10 O 0 0 0 E.L. DISEASE - POLICY LIMIT $5 0 0 , 0 0 0 OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHIOLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Those usual to the Insured's Operations. CFRTIFICATF FIn] nFR I I Ann mm xuuncm MAIIEFR IFr R• CANCFI I ATInh1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of Fort Collins EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 45 DAYS WRITTEN NOTICE (10 DAYS FOR NON-PAYMENT) TO THE CERTIFICATE Purchasing Division P.O. BOX 580 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 REPRESENTATIVES. Fort Collins, CO 80522-0580 AUTHORIZED REPNESENT&WE ACORD Zb-S (71971 c ACORD CORPORATION 1988 JCI ACORD. CERTIFICATE OF LIABILITY INSURANCE PNDC 03-OIAT2005 PRODUCER FLOOD & PETERSON INS INC/PHS/CONSO 342317 P: (86 6) 467-873 0 F: (877) 538-8526 P. O. BOX 29611 CHARLOTTE NC 28229 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 INSURED NORTHSTAR DESIGNS 700 AUTOMATION DR, UNIT 5 WINDSOR CO 80550 INSURERA:Hartford Casualty - Ins Co INSURER B: INSURER C: INSURER D: INSURER E: (`OVFRAGFS 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. MR TDATE TYPE OF INSURA ACE PolICY N(ANHER POLICYEEFECTIVE M1AfA2D1YY) POLICYEXPIRAT)ON L5NR5 GENERAL 1418IL1TV EACH OCCURRENCE S 1 0 0 O O 0 0 A COMMERCIAL GENERALLIABIUTV 34 SBA NF8434 04/13/04 04/13/05 FIRE DAMAGE (AnYonefire) s 3 0 0 000 CLAIMS MADE � OCCUUR MED EXP (AM one person) $ 1 O O O O X Business Liah PERSONAL B ADV INJURY $1 000 O 0 0 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s 2 0 0 O 0 0 0 POLICY PROJECT rXI LOC AUTOMOGME UABI11TY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) S BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accidern) S HIRED AUTOS NON OWNED AUTOS PROPERTY DAMAGE (Per accident) S GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S OTHER THAN EA ACC S ANY AUTO S AUTO ONLY: AGG EXCESSUAHILIJY EACH OCCURRENCE s OCCUR CLAIMS MADE AGGREGATE $ S i S DEDUCTIBLE S RETENTION s WORKERS COMPENSA TIONAND TH- TORY WC LIMITTATU ER EMPLOYERS' CIA8KITY E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE - POLICY LIMIT S O7HER DESCRIPTION OF OPERATIONS/LOCA TIONVVEINCLES/EXCL USIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Those usual to the Insured's Operations. CERTIFICATE Hnl DER I I ADDITIONAL INSURED: INSURER LETTER: CANCFI I ATInN 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 30 DAYS WRITTEN NOTICE (10 DAYS FOR NON-PAYMENT) TO THE CERTIFICATE Attn: John Stephen HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO P O BOX 580 OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Ft Collins, CO 80522-0580 A(/T/K1R/ZEO SENFAVAtf ACORD 25-S (7/97) C) ACORD CORPORATION 1988 Jc1 ACORD. CERTIFICATE OF LIABILITY INSURANCE PNDC TE 03-01 2005 PRODUCER FLOOD & PETERSON INS INC/PHS/CONSO 342317 P: (866) 467-8730 F: (877) 538-8526 P. O. BOX 29611 CHARLOTTE NC 28229 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 INSI.RED NORTHSTAR DESIGNS 700 AUTOMATION DR, UNIT 5 WINDSOR CO 80550 INSURER A:Hartford Casualty Ins Co INSURER B: INSURER C: NSURER D: INSURER E: COVERAGES 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. BYSR TYPE OF INSURANCE POLICY MANGER POLICY EFFECTIVE POLICY EXPIRATION LMQS GENERAL LIABILITY EACH OCCURRENCE s1,000,000 A COMMERCIAL GENERAL LIABILITY 34 SBA N F 8 4 3 4 0 4/ 13 / 0 4 0 4/ 13 / 0 5 FIRE DAMAGE (Any me IkO 13 0 0 0 0 0 CLAIMS MADE FX I OCCUR MED EXP (Arty one person) $1 O 0 0 0 PERSONAL & ADV INJURY $1 000 000 X Business Liab GENERAL AGGREGATE s2,000,000 GENT AGGREGATE LIMIT APPUES PER: PRODUCTS - COMP/OP AGG s2,000,000 ILOT FRI LOC POLICY 71 PSEC AUTOMOL&LE LIABILITY COMBINED SINGLE UMIT $ ANY AUTO (Ea accident BODILY INJURY $ ALL OWNED AUTOS SCHEDULED AUTOS (Per Person) BODILY INJURY $ HIRED AUTOS NON -OWNED AUTOS (Par acciderrt) PROPERTY DAMAGE $ (Per acciderrl) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO S AUTO ONLY: AGO EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE S S 4 DEDUCTIBLE S RETENTION S WORKERS COMPENSAT/ONAND WC STATU OTH- MI EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE 1 $ F.L. DISEASE - POLICY LIMIT 1 $ OTHER DESCRIPTION OF OPERA TION- LOCI TIONSVEHICLESIEXCLUSIONS ADDED BYEMIORSEMENTISPEGAI PROVISIONS Those usual to the Insured's Operations. U LKI IYIUAI L LIULULH ADDIIIUNAL INSURED) INSOREN LETILM I,AIIJULLLAIIUIV 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 30 DAYS WRITTEN NOTICE (10 DAYS FOR NON-PAYMENT) TO THE CERTIFICATE Attn : John Stephen HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO P O BOX 580 OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTFt Collins, CO 80522-0580 ACOHD 2b-S (1f911 'D ACORD CORPORATION 1988 ACORI?M CERTIFICATE OF LIABILITY INSURANCE 02/21/05°""' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Van Gilder Insurance Corp. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 700 Broadway, 1000 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR y ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Denver, CO 80203 303 837-8500 INSURERS AFFORDING COVERAGE INSURED INSURER A: Hartford Insurance (Service Center) North Star Design, Inc. INSURER B: Everest National Insurance Company 700 Automation Dr., Unit 1 INSURER C: Windsor, CO 80550 INSURER D: INSURER E: COVFRAGF3 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. INS R L R TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE '.POLICY DATE MM/DD/YV EXPIRATION DATE MM/DD/VY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any one tire) $ _ __ MED EXP (Any one person) $ _ j CLAIMS MADE L - J OCCUR!, PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ G EN'L AGGREGATE LIM IT APPLIES PER: PRODUCTS -COMP/OP AGG _ $ POLICY JECT LOG AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Perperson) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) - -.- HIRED AUTOS NON -OWNED AUTOS $ PROPERTY DAMAGE (Per accident) $ —_ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS LIABILITY EACH OCCURRENCE $ _ OCCUR ] CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE __- -. $ RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 134WEGKDO139 09/01104 09101/ is X. WC STATU- OTH- T RY LIMIT E.L. EACH ACCIDENT $100,000 E.L. DISEASE - EA EMPLOYEE'. $100,000 E.L. DISEASE -POLICY LIMIT _- $500,000 B OTHER Professional 48AE003420041 09/01/04 09/01/05 $1,000,000 per claim Liability $1,000,000 annl aggr. DESCRIPTION OF OPERATIONS/LOCATIONS(VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS City of Fort Collins Purchasing Division PO Box 580 Fort Collins, CO 80522-0580 ..--------.-- -.- SHOULD ANYOF TH E ABOVE DESCRIBED POLICIES SE CANCELLED B EFORE TH E EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30.___DAYSWRITTEN NOTICETOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL IMPOSE NO OBLIGATION OR LIABILITY OFANYKIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVE I—. I . VI I 1fV .- 000I1.IJI JV IV YVI ( Iionf*- d1fIR5 NORST ACORD- CERTIFICATE OF LIABILITY INSURANCE DATE 05/11/05D ) PRODUCER Flood & Peterson Insurance Inc 4821 Wheaton Drive P O Box 270370 Fort Collins, CO 80527 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 North Star Designs, Inc 700 Automation Drive, Unit I Windsor, CO 80550 INSURER A: The Hartford Insurance INSURER B: INSURER C: INSURER D: INSURER E: COVERAGES 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 TYPEOFINSURANCE POLICY NUMBER DATEYIEFDDIYYI PDLITYE ?RATION LIMITS A GENERAL LIABILITY 34SBANF8434 04/13/05 04/13/06 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED E300OOO CLAIMS MADE OCCUR MED EXP (Any one person) $1 O 000 PERSONAL & ADV INJURY $1 0QQ 000 GENERAL AGGREGATE $2 OOO OQQ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMPIOP AGG $2000000 POLICY PRo LOG AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND WC STATU- FIR EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS City of Fort Collins -Purchasing Attn: Jan P.O. Box 580 Fort Collins, CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL An 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 REPRESENTATIVE ,F"loocR r AA-,tv./ f 0,,Q o ZAJC . ACURD 25 (2001108) 1 of 2 #M314813 MVD 0 ACORO 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. AGORD 25-5 (2001/UU) 2 of 2 #M314813 SGPI ACORD. CERTIFICATE OF LIABILITY INSURANCE P4DC 02-18A-T2005 PRODUCER FLOOD & PETERSON INS INC%PHS/CONSO 342317 P: (866)467-8730 F: (877)538-8526 P. 0. BOX 29611 CHARLOTTE NC 28229 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 INSURED NORTHSTAR DESIGNS 444 CLEVELAND AVE WINDSOR CO 80550 INSURERA:Hartford Casualty Ins Cc INSURER B: INSURER C: INSURER D: INSURER E: COVERAGES 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 POLICY EFFECTIVE DATE MMIDDIVY POLICY EXPIRATION LRARS DATE MM/DD/YY GENERAL LIABILITY EACH OCCURRENCE $1 0 0 0 r 0 0 0 A COMMERCIAL GENERAL LIABILITY 34 SBA NF 84 3 4 04 / 13 / 0 5 04 / 13 / 0 6 1 FIRE DAMAGE (Any one fire) 1s300,000 CLAIMS MADE I X l OCCUR MED EXP IAny om Person) 1 $10 r 0 0 0 X Business Liab PERSONAL &ADV INJURY $1, 000, 000 GENERAL AGGREGATE I s2,000,000 PRODUCTS - COMP/OP AGG I s2,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY F I PECT X I LOC AUTOMOBILE LIABIUTY COMBINED SINGLE LIMIT & ANY AUTO (Ea accident) 8 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per Person) 5 HIRED AUTOS BODILY INJURY NON -OWNED AUTOS (Per accident) 5 PROPERTY DAMAGE (Per accident) GARAGE LIAMUTY AUTO ONLY - EA ACCIDENT S OTHER THAN EA ACC $ ANY AUTO S AUTO ONLY: AGG EXCESS LIABILITY EACH OCCURRENCE $ _ OCCUR u CLAIMS MADE AGGREGATE $ I$ $ DEDUCTIBLE $ RETENTION 4 WORKERS COMPENSATION AND OTH- WC STATUUNT- I ER EMPLOYERS' UASSM E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Those usual to the Insured's Operations. CERTIFICATE HOLDER I I ADDITIONAL INSURED: INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of Fort Collins EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE (10 DAYS FOR NON-PAYMENT) TO THE CERTIFICATE Attn • Purchasing Division PO BOX 580 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 REPRESENTFort Collins CO 80522 AUTHORIZED REPRESENTPPE "`sL� •,_t.T —' ACORD 25-S (7/97) t ACORD CORPORATION 1988 ACORD,M CERTIFICATE OF LIABILITY INSURANCE SDP DATE P4DC 02-18-2005 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION FLOOD & PETERSON INS INC/PHS/CONSO ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 342317 P: (866)467-8730 F: (877)538-8526 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. 0. BOX 29611 CHARLOTTE NC 28229 INSURERS AFFORDING COVERAGE INSURED INSURERA:Hartford Casualty Ins Co INSURER B: NORTHSTAR DESIGNS INSURER C: 444 CLEVELAND AVE INSURER D: WINDSOR CO 80550 INSURER E: COVERAGES 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 POL CY EFFECTIVE DATE MMIDDIYY POIN:V EXPIRATION LIMITS DATE MM/DDIYY GENERAL LIABILITY I EACH OCCURRENCE 51, 0 0 0, O 0 0 A COMMERCIAL GENERAL LIABILITY 34 SBA NF84 34 04 / 13 / 04 04 / 13 / 0 5 1 FIRE DAMAGE (Any one fire) S3 0 0 O 000 CLAIMS MADE I X I OCCUR MED EXP (Any one person) $10 , 0 0 0 X Business Liab PERSONAL 6 ADV INJURY 1111, 000, 000 GENERAL AGGREGATE S2 , 0 0 0, 0 0 0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 POLICY PRO- JECT I X LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S ANY AUTO (Ea accident) BODILY INJURY $ ALL OWNED AUTOS SCHEDULED AUTOS (Per person) BODILY INJURY $ HIRED AUTOS NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per axident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC S ANY AUTO $ AUTO ONLY: AGO EXCESS LIABILITY EACH OCCURRENCE $ _ OCCUR CLAIMS MADE AGGREGATE $ $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND WC STATUDRY- OTH- EMPLOYERS' LIABNJTY E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATNONSIVENICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Those usual to the Insured's Operations. CFRTIFICATF mm nFR I I arennnuer tum,own. txxtmon.e FR- CANCFI I ATIfON 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 30 DAYS WRITTEN NOTICE (10 DAYS FOR NON-PAYMENT) TO THE CERTIFICATE Attn: Purchasing Division 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 Fort Collins CO 80522 AUTHORIZED R�EP'1RESENTygyT-p-(�E PAavnu ZS-s (/IUI) t ACORD CORPORATION 1988