HomeMy WebLinkAboutJUPITER - INSURANCE CERTIFICATEACORD. CERTIFICATE OF LIABILITY INSURANCE 06121/os°�"'
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Van Gilder Insurance Corp. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
700 Broadway, Suite 1000 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Denver, CO 80203 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
303 837-8500 INSURERS AFFORDING COVERAGE
INSURED INSURER A: CNA(CL)
Jupiter I, L.L.C. dba OfficeScapes INSURER B: Pinnacol Assurance
9900 E. 51st Avenue INSURER C:
Denver, CO 80238 INSURER D:
INSURER E:
I WVQ V =o
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
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE M DD
POLICY EXPIRATION
T IMMIDDIYYI
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FXI OCCUR
C2078647069
10/01/05
10/01/06
EACH OCCURRENCE
$1,000,000
FIRE DAMAGE (Any one fire)
$200000
MED EXP (Any one person)
05,000
PERSONAL B ADV INJURY
$1 000 000
GENERAL AGGREGATE
$2 000 000
GEN'L AGGREGATE LIM ITAPPL IES PER:
POLICY PRO-
F T X LOC
PRODUCTS -COMP/OPAGG
$2 00O OOO
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON -OWNED AUTOS
C2078647024
10/01/05
10/01/06
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
A
EXCESS LIABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION $10 000
C2078646939
10/01/05
10/01/06
EACH OCCURRENCE
s5,000,000
AGGREGATE
$j 000 000
a
$
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
4014202
10/01/05
10/01/06
X WC STATULIM - I OTH-
EEL
E.L. EACH ACCIDENT
$1 000,000
E.L. DISEASE -EA EMPLOYEE
$1,000,000
E.L. DISEASE -POLICY LIMIT
$1,000,000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
The City of Fort Collins, Colorado, a Municipal Corporation, its officers, agents, and employees are included as Additional
Insureds under General Liability, as required by written contract.
The City of Fort Collins,
a Municipal Corporation
Attn: Director of Purchasing & Risk Management
PO Box 580
Fort Collins, CO 80522
SHOULD ANYOF THE ABOVE D ESCRIBED POLICIES BE CANCELLED BEFORE TH E EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICETOTHE CERTIFICATE HOLDER NAMED TOTH E LEFT, BUTFAILURE TODOSOSHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANYKIND UPON TH E INSURERJTS AGENTS OR
REPRESENTATIVE
ACORD 25S (7/97)1 of 1 fi_gArR'2S0/Md9ROr'A
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