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Home My WebLink AboutBOULDER DESIGN ALLIANCE ROB DEKEFFER - INSURANCE CERTIFICATEACORD. EVIDENCE OF PROPERTY INSURANCE PND 11-02-2005 THIS IS EVIDENCE THAT INSURANCE AS IDENTIFIED BELOW HAS BEEN ISSUED, IS IN FORCE, AND CONVEYS ALL THE RIGHTS AND PRIVILEGES AFFORDED UNDER THE POLICY. PRODUCER I PN°"Ho ay (8 6 6) 4 6 7 - 8 73 0 COWAW VAN GILDER INSURANCE CORP/PHS Hartford Casualty Ins Co PO BOX 33015 SAN ANTONIO TX 78265 CODE: 341438 sue CODE: AGENCY CUSTOMER ID It - INSURED LOANNUNBER POUCYNUNBER BOULDER DESIGN ALLIANCE ROB 34 SBA LJ6557 EFFECTNEDATE EKPM TIONDATE CONTINUED UNTIL DEKIEFFER 3002 MELISSA LANE 01/01 2006 01 01/2007 TERMINATED IF CHECKED TIM REPLACES PRIOR EVIDENCE DATED: BOULDER CO 80301 LOCAROWDESCMPTION Location: 001, Building: 001 CONSULTANT - NOC 3002 MELISSA LANE BOULDER CO 80301 COVERAGE INFORMATION COVERAGEIPERD.SIFORNS AMOUNT OFIWIMMANCE DEDUCTIBLE Policy Coverages: Special Form Including Theft Loss of Income(Business Income with Extra Expense) Systems Breakdown - With Boilers Location Level Coverages: Business Personal Property - Replacement Cost $16,400 $500 2005NQV22 gm.10:23 CANCELLATION THE POLICY IS SUBJECT TO THE PREMIUMS, FORMS, AND RULES IN EFFECT FOR EACH POLICY PERIOD. SHOULD THE POLICY BE TERMINATED, THE COMPANY WILL GIVE THE ADDITIONAL INTEREST IDENTIFIED BELOW 45 DAYS WRITTEN NOTICE (10 DAYS FOR NON-PAYMENT), AND WILL SEND NOTIFICATION OF ANY CHANGES TO THE POLICY THAT WOULD AFFECT THAT INTEREST, IN ACCORDANCE WITH THE POLICY PROVISIONS OR AS REQUIRED BY LAW ANNEANDADDRESS City of Fort Collins Attn: Jan Elliott 256 W. Mountain Avenue Fort Collins, CO 80521 MORTGAGEE I I ADDITIONAL INSURED AUTHORIZED REPRESENTATIVE AUUHU Z/ (JIUJ) CACORD CORPORATION 1993 ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE 11-02-2005 PRODUCER VAN GILDER INSURANCE CORP/PHS 341438 P: (866)467-8730 F: (877)905-0457 PO BOX 33015 SAN ANTONIO TX 78265 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 BYTHE OUGIESBELOW. INSURERS AFFORDING COVERAGE INSURED BOULDER DESIGN ALLIANCE MR. ROB DEKIEFFER 3002 MELISSA LN. BOULDER CO 80301 INSURERA:Hartford Casualty Ins Co INSURER B: INSURER C: INSURER 0: 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 TYPEOFINSUMNCE POLICY NUMBER PO DATE MMFDDM/ DA YMM/DD1nYYNLIMITS A GENERAL LIA&UfY COMMERCIAL GENERAL LIABILITY CLAIMS MADE U OCCUR X Business Liab 34 SBA LJ6 5 5 7 01 / 01 / 0 6 EACH OCCURRENCE 01 / 01 / 0 7 1 FIRE DAMAGE (Any one fit.) 1s300,000 MED EXP (Any one person) PERSONAL &ADV INJURY I GENERAL AGGREGATE 1s2,000,000 PRODUCTS - COMPIOP AGG s1 , 00 0, 0 00 $10 , 0 0 0 a, 000, 000 GENT AGGREGATE LIMIT APPLIES PER: POLICY I X I PECT RO LOC J s2 , 0 0 0 , 0 0 0 A AUTOMOBR.E LIASILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 34 SBA LJ6557 01/01/06 01/01/07 COMBINED SINGLE LIMIT (Eaa identl ol, 000, 000 BODILY INJURY (Per person) S X BODILY INJURY (Per wadent) $ X PROPERTY DAMAGE (Per a deml $ GARAGE LIABUM ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG S $ EXCESS LIABILITY _ OCCUR u CLAIMS MADE DEDUCTIBLE RETENTION S EACH OCCURRENCE $ AGGREGATE $ $ $ $ WORKERS COMPENSATION AND EMPLOYERS• LIABILITY WC STATDRY LIM U- OTH- ER E.L. EACH ACCIDENT $ El, DISEASE - EA EMPLOYEE S E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERA7M%SILOCATK)NSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Those usual to the insured's operations. City of Fort Collins Attn: Jan Elliott 256 W. Mountain Avenue Fort Collins, CO 80521 DULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 31RATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE J10 DAYS FOR NON-PAYMENT) TO THE CERTIFICATE LDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO LIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR A ORI D R ESE�NiATIY� ACORD 25-5 17197) 0 ACORD CORPORATION 1988