HomeMy WebLinkAbout125038 H AND H DATA SERVICES INC - INSURANCE CERTIFICATEFrom: Valerie At: Front Range Insurance FaxID: 970-225-6596 To: Ed Bonnette Date: 1/18/2006 03:30 PM Page: 2 of 2
CERTIFICATE OF LIABILITY INSURANCE OF ID
DATE(MMIDO/YYYYI
.ACDi4D_ HHELE-1
01/18/06
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Front Range Insurance Group
1109 Oak Park Drive Suite 101
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins CO 80525
Phone: 970-223-1804
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURER A st Paul Ttavalars Inauranca
INSURER 8.
H & H Data Services
Joe Hehn
N
SURER c
NsuRERD:
1310 Webster Avenue
Fort Collins CO 80524
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
SR
TYPE OF INSURANCE
POLICY NUMBER
DATE (MMIDDNY]i
DATE (MMIDDNY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
X
X COMMERCIAL GENERAL LIABILITY
660348SB36000F04
07/01/05
07/01/06
PREMISES(Eaoccurence)
$ 100,000
CLAIMS MADE [j] OCCUR
MEP EXP (Any one person)
$ 10,000
PERSONAL &ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER
PRODUCTS - COMP/OP AGG
$2, 000, 000
POLICY JEC LOC
A
AUTOMOBILE
LIABILITI'
ANY AUTO
810906IW493PHX04
07/01/05
07/01/06
COMBINED SINGLE LIMIT
(Ea accident
$ 1 000 000
BODILY INJURY
(Per person)
$
X
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident)
$
X
X
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY'. AGG
$
ANY AUTO
$
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
X I OCCUR �CLAIMSMADE
ISMCUP9045W20AIND04
07/01/05
07/01/06
AGGREGATE
$
$
$
DEDUCTIBLE
X RETENTION $ 5 , 000
$
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
STATU-
TORY LIMITS ER
E.L. EACH ACCIDENT
$
EL. DISEASE - EA EMPLOYEE
$
OFFICER/MEMBER EXCLUI
l yes, describe under
SPECIAL PROVISIONS below
EL DISEASE - POLICY LIMIT
$
OTHER
A
Property Section
660348SB36000F04
07/01/05
07/01/06
BPP $38,760
A
Equipment Floater
16603488B36ocorO4
07/01/05
07/01/06
1 Ded. $250
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
The City of Fort collins is listed as Additional Insured with regards to
general liability. Bid #5757 Cabling - Fiber Optic s Copper
CERTIFICATE HOLDER CANCELLATION
FORTC-1
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
City Of Fort Collins
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO $O SHALL
Ed Bonnette
P.O. BOX 580
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Fort Collins CO 80522-0580
REPRESENTATIVES.
AUTHO PRESENTATIVE
G. ccJ
ACORD 25 (2001108) Q ACORD CORPORATION 1998
From: Valerie At: Front Rance Insurance Fa%ID: 970-225-6596 To: Ed Bonnette
Date: 1/1WOO 03:30 PM Pace: 1 of
Fax
Phone: (970) 223-1804 ext. 200
Fax: (970)225-6596
From: Valerie To: Ed Bonnette
Pages: 2 Fax: 2216707
Date: 1/18/2006 03:26:15 PM Phone:
Subject: Certificate of Insurance
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