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HomeMy WebLinkAboutTELESUPPORT H AND H DATA AXIS NETWORKS - INSURANCE CERTIFICATE (2)ACORDa CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD[YYYY) 06/06/2005 PRODUCER (303)442-1484 FAX (303)442-8822 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Taggart & Associates, Inc. 1600 Canyon Boulevard ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. 0. Box 147 Boulder, CO 80306 INSURERS AFFORDING COVERAGE NAIC # INSURED TELESUPPORT SERVICES INC INSURERA: Phoenix 25623 4830 PEARL ST INSURERB: Travelers Indemnity 25658 BOULDER, CO 80301 INSURERC: Pinnacol Assurance 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. INSR kDD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE IMMIDOMI POLICY EXPIRATION DATE IMMfDDNYI LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR I68O7768W116PHX05 05/23/2005 05/23/2006 EACH OCCURRENCE $ 1,000,00 DAMAGE TO RENTED $PRFMIRF.q 300,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2 r 000 , OO GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PROJECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON-OWNEDAUTOS I6807768W116PHX05 05/23/2005 OS/23/2006 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANYAUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ B EXCESS/UMBRELLA LIABILITY X OCCUR CLAIMS MADE RXDEDUCTIBLE RETENTION $ 5 , 00 ISFCUP7768W221IND05 05/23/2005 05/23/2006 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 $ $ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 3454055 10/01/2004 10/01/2005 I WC STATU- I JOTH- E.L. EACH ACCIDENT $ 500,00 E.L. DISEASE - EA EMPLOYEE $ SOO 0O E.L. DISEASE - POLICY LIMIT $ SOO, 0O OTHER DESCRIPTION OF OPERATIONS / LOCATIONS! VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS e: Bid #5757 Cabling - Fiber Optic & Copper City of Fort Collins Attention: Ed Bonnette, C.P.M. Purchasing Division 215 North Mason Street 2nd Floor Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 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 //�,� Michael Taggart CPCU CIC/TF' "" ACORD 25 (2001/08) FAX: (97U)[Z1-b7U7 ©ACORD 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. ACORD 25 (2001/08) ACORDM CERTIFICATE OF LIABILITY INSURANCE DATE (MM DDIYYYY) 06/06/200S PRODUCER (303)442-1484 FAX (303)442-8822 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Taggart & Associates, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1600 Can on Boulevard I HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR y P. 0. Box 147 Boulder, CO 80306 INSURED TELESUPPORT SERVICES 4830 PEARL ST BOULDER, CO 80301 Vt will A:I_lCJ ;all INSURERS AFFORDING COVERAGE INSURERA: Phoenix INSURERS: Travelers Indemnity INSURERC: Pinnacol Assurance INSURER D: INSURER E: NAIC # 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 DD' rypE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE IMMIDDMI POLICY EXPIRATION DATE IMMIDO/M 05/23/2006 LIMITS GENERAL LIABILITY I6807768W116PHX05 05/23/2005 EACH OCCURRENCE S 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE T OCCUR DAMAGE TO RENTEDPREMISES ..J $ 300,000 $ S,00 MED EXP (Any one person) PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 AUTOMOBILE LIABILITY ANY AUTO I6807768WI16PHXOS 05/23/2005 05/23/2006 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 BODILY INJURY (Per person) $ A ALL OWNED AUTOS SCHEDULEDAUTOS HIREDAUTOS NON -OWNED AUTOS X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO 1 OTHER THAN EA ACC $ AUTO ONLY: AGG $ B EXCESS/UMBRELLA LIABILITY X OCCUR CLAIMS MADE ISFCU07768W221IND05 05/23/2005 05/23/2006 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,00 $ DEDUCTIBLE X RETENTION $ 5, 00 $ $ WORKERS COMPENSATION AND 3454OSS 10/01/2004 10/01/2005 I WCSTATU I oTH- EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 500,000 C ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - EA EMPLOYE $ 500,00 E.L. DISEASE - POLICY LIMIT $ S00' 00 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS e: Bid #5757 Cabling - Fiber Optic & Copper City of Fort Collins Attention: Ed Bonnette, C.P.M. Purchasing Division 21S North Mason Street 2nd Floor Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 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 /j�,� ��� �C.. Michael Taggart CPCU CIC/TF' Q /�%T A%;VKUZO(ZUUT/UU) rhA; l7Y VJGG I—oYV/ ®ACORD 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. ACORD 25 (2001/08) ACORD, CERTIFICATE OF LIABILITY INSURANCE DATE /D O6/06/2005) 005 PRODUCER (303)442-1484 FAX (303)442-8822 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Taggart & Associates, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1600 Can on Boul eva rd I HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR Y P. 0. Box 147 Boulder, CO 80306 INSURED TELESUPPORT SERVICES 4830 PEARL ST BOULDER, CO 80301 Mel? z INSURERS AFFORDING COVERAGE INSURERA: Phoenix INSURERS: Travelers Indemnity INSURERC: Pinnacol Assurance INSURER D: INSURER E: NAIC # 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 DD' TYpE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FX OCCUR I6807768WI16PHX05 05/23/2005 05/23/2006 EACH OCCURRENCE $ ],r 000 00 DAMAGE TO RENTED PRFMIRFq $ 300,000 MED EXP (Any one person) $ 5,00( PERSONAL & ADV INJURY $ 1,000,00( GENERAL AGGREGATE $ 2,000,00( GENT AGGREGATE LIMIT APPLIES PER: X I POLICY M PRO- JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,00( A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS I6807768W116PHXOS 05/23/2005 05/23/2006 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ B EXCESS/UMBRELLA LIABILITY X OCCUR CLAIMS MADE DEDUCTIBLE X RETENTION $ 5,00C ISFCUP7768W221IND05 05/23/2005 05/23/2006 EACH OCCURRENCE $ 11000,00 AGGREGATE $ 1,000,000 $ It C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 34540S5 10/01/2004 10/01/2005 WC STATU- JOTH- FR E.L. EACH ACCIDENT $ 500, 0O E.L. DISEASE - FA EMPLOYEE $ 500,00 E.L. DISEASE - POLICY LIMIT $ 5DD , 00 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS City of Fort Collins Attention: Ed Bonnette Purchasing Division 215 North Mason Street 2nd Floor Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 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 /y� Michael Taaaart CPCU CIC/TF'X '4- 'Q / ACORD 25 f2001iom FAX: (970)221-6707 �, ernen nnoonnwrrnu •nee 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. ACORD 26 (2001/08)