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Home My WebLink AboutWESTRIAN GROUP JR ENGINEERING - INSURANCE CERTIFICATE (2)ACORD. CERTIFICATE OF LIABILITY INSURANCE 9i16i2°°' 5"' PRODUCER FAX (303) 370-0118 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Moody Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 3773 Cherry Creek North Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 800 Denver CO 802093804 INSURERS AFFORDING COVERAGE NAIC 0 INSURED INSURER A'. Lexington Insurance Westrian Group, Inc. INSURERS Nationwide Mutual DBA: JR Engineering, LLC INSURER A=t Guarantee Liab Ins 6050 Greenwood Plaza Blvd. INSURER D: Pinnacol Assurance INSURER Greenwood Village CO 80111 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 OFANY 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, LLTR NORD TYPE OF INSURANCE POLICY NLMBER POLICYTIVE DATE (M DDDNY N LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMSMADE FX7 OCCUR X 05,000 Dad. 0328876 10/31/2004 10/31/2005 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES E9 occurrence SO OOO $ r MEDEXP An oneperson) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES PER JECT LOC PRODUCTS- COMPIOP AGO $ 2,000,000 B AUTOMOBILE LIABILITY ANY AUTO ALL ONMED AUTOS SCHEDULED AUTOS HIRED AUTOS NON.OVVNED ALTOS ACPBA7501657648 10/01/2004 10/01/2005 COMBINED SINGLE LIMIT (Ee accident) $ 1,000,000 X BODILY INJURY (Per oersm) $ BODILY INJURY (Peraccident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGO $ $ C EXCESSfUMBRELLALIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ A005088801700 10/01/2004 10/01/2005 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOPJPARTNERIEXECU71VE OFFICERMIEMBER EXCLUDED? f yes, describe under SPECIAL PROVISIONSbHow 4086235 10/01/2004 10/01/2005 MIS E.L. EACH ACCIDENT $ 1,000,000 EL DISEASE -EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 B OTHER Inland Marine ACPCIX7501658339 10/01/2004 10/01/2005 sch.aquip.$1,040,74 Leased/Rented Equip. Deductible 11,000 DESCRIPTION OF OPERATIDNSILOCATIONSfVEHCLESMXCLUSIONS ADDEO BY ENDORSEMENTISPECAL PROVISIONS blanket Additonal Insured as required by written contract. blanket waiver of subrogation. By state law, 10 day notice Of cancellation applies to non-payment of premium. (970)221-6707 City of Fort Collins 215 North Mason St 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 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TD THE: LEFT, SLR FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE TO AGENTS OR REPRESENTATIVES. DREPRESENTATNE StoffeUPMC ^a wmw co jcuuvuel 0 ACORD CORPORATION 1988 INAR9R Iwo)nA AMR VhIP M4 rfnmp nlutinnc In, fAnN.117.nF4, Pmel rib 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. W I N8025(010s).0i Page oft