HomeMy WebLinkAboutQUANTUM WEST INC - INSURANCE CERTIFICATEClient#, 18AR0
ACORDI,. CERTIFICATE OF LIABILITY
INSURANCE
VYY)
0DATE5IO25/0218
/08
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Compass Insurance Agency, Inc.
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Olson & Olson Division
750 W. Hampden Avenue, Ste 440
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Englewood, CO 80110
INSURERS AFFORDING COVERAGE
NAIC #
INSURED Quantum West, Inc.
P.O. Box 337240
Greeley, CO 80633
INSURERA: American Casualty Company
INSURER B:
INSURER C:
INSURER 0:
NSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TIRE 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 I$ SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
LTR
TYPEOF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
PATE MMIODIVY
POLICY EXPIRATION
DATE M 10b
LIMITS
A
GENERAL
LIABILITY
2026585260
06/14/08
06/14/09
F.ACH OCCURRENCE
S1,000,000
X
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE O OCCUR
DAMAGE TO RENTED
$300 000
$10 000
MED EXP (Any one Person)
. PERSONAL A AOV INJURY
$1000000
GENERAL AGGREGATE
$2,000,000
AGGREGATE LIMIT APPLIES PER:
_PRO-
JECT
PRODUCTS-COMPIOPAGG
$20000�___
,GEN'L
A
AUTOMOBILE
LIABILITY
ANY AUTO
2026586260
06/14/08
06/14/09
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
_
BODILY INJURY
(Psi Person)
.__.._.-._..._.
S
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Per accitlenU
$
HIREDAUTOS—
NON-OWNEDAUTOS
X
PROPERTY DAMAGE
(Per accident)
$
—
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO---
-
S
—
AUTO ONLY: AGG
EXCESSIUMBRELLA LIABILITY
OCCUR u CLAIMS MADE
_ EACH OCCURRENCE
$
AGGREGATE
$
___...__-......-._.._.-
..
S
DEDUCTIBLE
F.
$
.—..-__
RETENTION _._F _.......—
._
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
._._
_
WET OTH.
-T_QRYJJMI
E.L.EACH ACCIDENT
$
ANY PROPRIETOR/
E.L. DISEASE - EA EMPLOYEE
_ __
$
EXCLUDED'
OFFICERIMEMBER EXCILDED?
I(yes, describe under
F..1-.DISEASE-POIt_CY_L1_MI'f
S
SPECIAL PROVISIONS below
OTHER
"Except 10 days
V _
for non-payment
of premium.
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS
City of Fort Collins
Purchasing
P.O. Box 580
Fort Collins, CO 80522
LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL �30 DAYS WRITTEN
E TO THE CERTIFICATE HOLDER NAMED 10 THE LEFT, BUT FAILURE TO 00 SO SHALL
OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
AUTHORIZED REPRESENTATIVE
10., e
r+ww <v(avuoo7l OTZ #537Z174/M37Z163 30DLS 0 ACORD CORPORATION 1988
ACORDn, CERTIFICATE OF LIABILITY INSURANCE
Compass Insurance Agency, Inc.
Olson & Olson Division
750 W. Hampden Avenue, Ste 440
Englewood, CO 80110
Quantum West, Inc.
P.O. Box 337240
Greeley, CO 80633
ONLY AND
HOLDER.T
INSURERS AFFORDING COVERAGE
wsURERAPhiladelphia Indemnity
INSURER 8:
INSURER C:
INSURER D:
INSURER E:
DATE (MMIODNYYY)
05/02/08
MATTER OF INFORMATION
PON THE CERTIFICATE
NOT AMEND, EXTEND OR
BY THE POLICIES BELOW.
NAIC 0
IS Co 1 18058
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR'fHE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS DER HFICAT'IE 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.
LTR
N
TYPEOFINSURANCE
POLICY NUMBER
POLICY EFFECTIVE
O!W
POLICY —EXPIRATION
DATE I DD/YY
LIMITS
GENERAL LIABILITY
_EACH OCCURRENCE
S
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
DAMAGEPRIEMIS_TO RENTED
$
MED EXP (Any one person)
S
PERSONAL&AOV IN,
S
GENERAL AGGREGATE
$
GEN'L AGGREGATE: LIMIT APPLIES PER:
_ POLICY _ rRCOT LOC
PRODUCTS_-COMPIOP AGG
S
��-�--
---u
_
AUTOMOBILE
A-
LIABILITY
-�_—
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$
ALL OWNED AUTOS—__--
—�—
SCHEDULED AUTOS
130011 Y INJURY
(Pe, person)
§
HIRED AUTOS-
NONOWNED AUTOS
BODILY
(Per nccitlenderl) p
$
PROPERTY DAMAGE
(Per accident)
S _
GARAGE LIABILITY
"Except 10 days
AUTO ONLY - EAACCIDENT
$
.,�
ANY AUTO
for non-payment
Of premium.
OTHER TPIAN EAACC
ALTO ONLY: AGO
$
$
EXCESSIUMBRF.LI.A LIABILITY
EACHOCCURRENCE
$_
_
AGGREGATE
$
OCCUR �.J CLAIMS MADE
.........._._.._
DEDUCTIBLE..
b u
RETENTION 5
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
WC STATU- 0711-
4RY1UdLTS
E.L. EACHACCIDENT
- A—
§
ANY PROPRIETOMPARTNERIEXECUTIVE
OFFICERIMEMBER EXCLUDED?
Ifyes.descdbeunder
EL DISEgSF_EA EMPLOYEE
---'— "-
5
_
C.L. DISEASE. POLICY LIMIT 5
Per Claim $1,000,000
Aggregate $1,000,000
A
SPECIAL. PROVISIONS below.
OTHER Professional
Liability
HS
PD190233
06/14/07
O6/14/08 1
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLE$ I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
"Per Claim" and "Annual Aggregate" limits apply per project. Payment of claims, defense
costs and claims expenses reduce the limit.
City of Fort Collins
Purchasing
P.O. Box 580
Fort Collins, CO 80522
LC ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL *30 DAYS WRITTEN
'E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
;ENO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
AUTHORIZED REPRESENTATIVE
-••----•-•---, r of < afasrnoy/msrz Ens 30DLS (E) ACORD CORPORATION 1988