HomeMy WebLinkAboutSKUMATZ ECONOMIC RESEARCH ASSOCIATES - INSURANCE CERTIFICATE (2)ACORIP, CERTIFICATE OF LIABILITY INSURANCE 04/OS/z 6'
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
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1600 Canyon Boulevard ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P. 0. Box 147
Boulder, CO 80306 INSURERS AFFORDING COVERAGE NAIC #
INSURED Skumatz Economic Research Associates, Inc. INSURERA: Hartford Casualty Insurance Co 129424
762 Eldorado Drive, Suite 100
Superior, CO 80027
INSURER B: Twin City Fire Ins Co
INSURER C:
INSURER D:
INSURER E:
COVERAvw
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
D'
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MMIDDfYY1
POLICY EXPIRATION
DATE (MMIDD"
LIMITS
GENERAL LIABILITY
34SBAPAS100
03/12/2006
03/12/2007
EACH OCCURRENCE
$ 2,000,000
DAMAGE TO RENTED
$ 300,00(
X COMMERCIAL GENERAL LIABILITY
MED EXP (Any one person)
$ 10,00(
CLAIMS MADE rX] OCCUR
PERSONAL & ADV INJURY
$ 2,000,00(
AIf--
GENERAL AGGREGATE
$ 4,000,00(
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 4,000,00(
POLICY JEC LOC
AUTOMOBILE
LIABILITY
ANY AUTO
34SBAPASIOO
03/12/2006
03/12/2007
COMBINED SINGLE LIMIT
(Ea accident)
$
2,000,000
BODILY INJURY
(Per person)
$
A
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Par accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
ANY AUTO
$
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
$
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION AND
34WECGMS199
03/12/2006
03/12/2007
WC STATU- OTH-
E.L. EACH ACCIDENT
$ 100,000
B
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED?
E.L. DISEASE - EA EMPLOYEE
$ 100,000
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE -POLICY LIMIT
$ SOO OO
,
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
t is agreed that the Certificate Holder named below is included as an Additional Insured for
General Liability.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WALL ENDEAVOR TO MAIL
City of Fort Collins
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Attn : James B. O'Neill - Purchasing
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
P.O. BOX 580
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE �
Fort Collins, CO 8OS22
G� Joan McDonald JPM
ACORD 25 (2001108) FAX: (97U)LC1-6/U/ OACORD CORPORATION 1983
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 (2001108)