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HomeMy WebLinkAbout398304 LAUREL HILL GIS - INSURANCE CERTIFICATE (3)ACORQ CERTIFICATE OF LIABILITY INSURANCE FMmxwYYM 08/29/2006 nROD xm 303 939-99 1 FAX (303 939-9926 Herbert -Leavitt Longmont 275 South Main Street Suite 208 Longmont, CO 90501 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE AL�TTHEECCOVE AFFORDED BYTTHE AMEND,ND OR BELOW. INSURERS AFFORDING COVERAGE NAIL # INSURED Laurel Hi I 1 615 Inc 307 Bross St Longmont, CD 80S01 INSURERA: Maryland Casualty Company 193SG INSURERB Pinnacol Assurance INBURERc Philadelphia insurance Co INSURER Or. INSURER E 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 POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAIMS TYPE OF SMSIIRANCE POLICY HUMBEI EFFECTIVE LIMITS GENERAL LIABILITY PP5037575108 02/01/2 02/01/ZO07 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL UIME Y DAMAGETORElTM $ 1,000,0001 MEDEXP(AWy pa ) $ 10,0001 CUAMSMADE OOCCUR A PERSONAL a ADV INJURY _ $ EXcl M GENERAL AGGREGATE $ 21000, GENL AGGREGATE LMITAPPLIES PER: PRODUCTS-COMFYOPAGG $ 2.000.00( POLICY JE�CT El LOC AUTOMOBILE LEA NUTY ANY AUTO PP5037575108 02/6l/2006 02/01/2007 COMBINED SINGLELMIT (Ea 90d°R'R) $ 1,000 BODILY INJURY (PwP) $ A ALL OWNEDAUTOS SCHEDULED AUTOS X HIREDAU IDS X NGFOMEDAUTOS BODLYIN.IURY Mwa=k%M $ PROPERTY DAMAGE (PERacciaant) $ GARAGE LIABILJTY AUTO ONLY -EA ACCIDENT $ OTHERTHAN EAACC AUTDONLY: AGG S ANYAUTO $ MICESSIIN/REILLA UABRJTY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ S S DEDUCIBLE S RETENTION $ 4091796 04/01/2006 04/01/2007 X "rSTAT11 OTRI- 1 EL EACH ACCIDENT $ 500 B IWORICERSOOMPENSATIONAND EMPLOYERS' LIABILITY MY PROPRIErORIPARTNER11DUBOUTIVE OFFK39WEMSM EXCLUDED? E.L. DISEASE- EA EMPLOYEE $ 5OO M. �P O=S bHow E.L. DISEASE- POLICY LIMIT S 500 C LOTHER rrors 8 Omissions r PHSD160401 10/26/2005 10/26/2006 $1,000,000 per Claim 1,000,000 Aggregate I I I I 27,S00 Deductible DEscwHON OFOPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADD® BY ENDORSEMENT SPECIAL PROVISIONS ll Locations / All Operations Pti�A1 Y I eA\M!CI I ATWW SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EAPIRATION DATE THEREOF, THE MUM POURER VRLL ENDEAVOR TO MAR City of Fort Collins Attn: John Stephens 30 DAYS IOUTTE"H°flCE TO THE CITE HOLDER MIN® TD THE uwr, BUT FABLRE TO MAIL SUCH NOTICE SHALL BPOSE NO OBLIGATION OR LIABILITY PO BOX 58O OF AM KOD UPON THE BOURER, ITS AGENTS OR R OftM TAm1EL AUTHOMM REPRESENTATIVE De metra Rafe DERAME �ae'.eI` '� IT I Fort Collins, CD $0522 ACORD 25 (2007A1h CACORD CORPORATION 1055 PDF created with FinePrint pdfFactory trial version www.pdffactory.com 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 irrsurer(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 (2001100) PDF created with FinePrint pdfFactory trial version www.Ddffactory.com