HomeMy WebLinkAboutJUPITER - INSURANCE CERTIFICATE (2)Client@- 2631
111PI
aMM. CERTIFICATE OF LIABILITY
INSURANCE
06/2;; 6°"Y'
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Van Gilder Insurance Corp.
700 Broadway, Suite 1000
y
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver, CO 80203
303 837-8500
INSURERS AFFORDING COVERAGE
INSURED
INSURER A: CNA (CL)
Jupiter I, L.L.C.
dba OfficeScapes
9900 E. 51 at Avenue
Denver, CO 80238
INSURERS: Pinnacol Assurance
INSURER C:
INSURER D:
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.
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE IMWDDNY)
POLICY EXPIRATION131L
DATE (MMOD111M
LIMBS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 7 OCCUR
C2078647069
10/01/05
10/01/06
EACH OCCURRENCE
$1000000
FIRE DAMAGE (Anyone fire)
$200000
MED EXP (Any one Person)
$15 000
PERSONAL &ADV INJURY
$1,000,000
GENERAL AGGREGATE
$2 000 000
GEN'L AGGREGATE LIM ITAPPLIES PER:
PRO X LOC
POLICY 71 JECT
PRODUCTS-COMPIOPAGG
$2 000 000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
C2078647024
10/01/05
10/01/06
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per parson)
$
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
$5 000 000
AGGREGATE
$5 000 000
E
$
$
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
4014202
10/01/05
10/01/06
-
X WC STATU- OTHR ER
Y LIMITSB
E.L. EACH ACCIDENT
51 00,000
E.L. DISEASE - FA EMPLOYEE
$1,000,000
E.L. DISEASE -POLICY LIMIT
$1,000,000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS 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
i
ACORD 25S (7/9714 ..s 4 0QACR2CQ11U1A'3a0R2
ANYOFTHE ABOVE D ESCRIBED
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL 39—. DAYSWRITTEN
NOTICE TOTHE CERTIFICATE HOLDERNAIAED TOTHE LEFT, BUTFAILURE TO DOSOSH ALL
IMPOSE NO OB LIGATION OR LIABILITY OF ANY 19ND UPON TH E INSURER,ITS AGENTS OR
REPRESENTATIVE
eee ra ncnnn cnRanRATlnM flans