HomeMy WebLinkAbout310036 BLUE DOT SOLUTIONS INC - INSURANCE CERTIFICATE (7)ACORD. CERTIFICATE OF LIABILITY INSURANCE
°A TE
03-06-2006
PRODUCER
COBIZ INSURANCE, INC/PHS
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
340725 P: (866)467-8730 F: (877)905-0457
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
PO BOX 33015
SAN ANTONIO TX 78265
INSURED
INSURERA:Hartford Casualty Ins Co
INSURER B:
INSURER C:
BLUE DOT SOLUTIONS, INC
INSURER D:
1900 GRANT ST . STE 1200
INSURER E:
DENVER CO 80203 1
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 TYPE OF INSURANCE
LTi1
PoLICV NUMBER POLIOY EFFECTIVE
DATE MMIDDIYY
PoLICV EXPIRATION LIMITS
DATE MMIDD/YY
GENERAL LIABILITY
I EACH OCCURRENCE 1
$1, 000, 000
A
COMMERCIAL GENERAL LIABILITY
34 SBA RU5908
02/13/06
02/13/07 1 FIRE DAMAGE (Any one fire)
$1, 000, 000
$10 , 0 0 0
CLAIMS MADE U OCCUR
MED EXP (Any one person)
$1, 000, 000
X Business Liab
(PERSONAL &ADV INJURY
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
s2,000,000
POLICY I I PROECT X LOC
J
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per person)
9
HIRED AUTOS
NON -OWNED AUTOS
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
GARAGE LIABB.ITY
AUTO ONLY - EA ACCIDENT
$
$
ANY AUTO
OTHER THAN EA ACC
AUTO ONLY: AGG
$
EXCESS LIABILITY
EACH OCCURRENCE s2,000,000
A
X OCCUR u CLAIMS MADE
34 SBA RU5908
02/13/06
02/13/07 AGGREGATE s2, 000, 000
$
DEDUCTIBLE
$
X RETENTION $10, 000
$
WORKERS COMPENSATION AND
LIABILITY
WC STATU-
Y OTHEREMPLOYERS'
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONSILOCATKINSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Those usual to the Insured's Operations.
CERTIFICATE HOLDER I X I ADDITIONAL INSURED; INSURER LETTER: _ CANCELLATION
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 • Jim Hume
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
REPRESENTATIVES.
Fort Collins CO 80522
pORDR�,v�ESEN ATI
ACORD 25-S (7I97) v ACORD CORPORATION 1988