HomeMy WebLinkAboutCOOVER CLARK AND ASSOCIATES - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE OPID B DATE (MI
PRODUCER
COOVE-1 08/30/04
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Olson & Olson It
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P O
HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR
Box 1467
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Englewood CO 80150
Phone 303-761-0085 Fax 303-788-1817
INSURERS AFFORDING COVERAGE
INSURED
NAIC#
INSURER N ti n 1 Nlr ➢u f Na tf rd
20478
INSURERS Continental Casualty Co
20443
Coover-Clark & As ociates P C
INSJR£RL
455 Sherman St 1205
Denver CO 80203
IN uRERo
NSURER
COVERAC.FS
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLIL.Y 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 ROLICIES 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
NSR
TYPE OF INSURANCE
POLICY NUMBER
DATE (MMIDDIYY)
GATE IMM/DDM)
LIMBS
GENERAL
LIABILITY
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
Blanket Addl I
2054533163
10/20/01
10/20/04
EACH OCCURRENCE
$ 1000000
PREMISED E3 G,CLPnOe)
$ 300000
MED EkP IAnY one person)
$1DDDD
PERSONAL a ADVINJURY
$1000000
•X
Blkt $ubr0 Waiver
er
GENERAL AGGREGATE
$ 2000000
G ENL AGGREGATE L IMIT APPLIES PER
PRODUCTS COMP/OP AGG
$2000000
POLICY FIX -TX JEC LOP
AUTOMOBILE
LIABILITY
A
ANYAUTO
2054533163
10/20/01
10/20/04
COMBINED SINGLE LIMIT
(Ea aYG denq
$1000000
ALL TWINED AUTO
BODILY INJURY
(Pe Gerson)
$
SCHEDULED AUTOS
X
HIREDAUTOS
BODILY IN HI
Po acatl )
$
X
NON ENDED AUTOS
PROPERTY DAMAGE
(Per ecaaenp
$
GARAGE LIABILITY
MY ALTO
EXCESSNMBRELLA LIABILITY
•NIICfpT MR 30 GAYS PON
NON PA=f ON PRIMMI
AUTOONLY EAACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY AGO
$
$
A
X OGGLR CLAIMS MADE
2054533163
10/20/01
10/20/04
EACH OCCURRENCE
$2000000
AGGREGATE
$2000000
$
FEEL ICTIBLF
$
X RETENTION $ 10000
WORMERS COMPENSATION AND
B
EMPLOYERS LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED'
WC2054837044
10/20/03
10/20/04
X TORY LIMITS ER
EL EACH ACCIDENT
$500000
EL DISEASE EAEMPLOYEE
$500000
IYe des IbeUme
SPECIAL PROVISIONS below
EL DISEASE POLICY LIMIT
$ 500000
OTHER
A Valuable Papers 2054533163 10/20/01 10/20/04I Limit $100 000
DESCRIPTON OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDEO BY ENDORSEMENT / SPECIAL PROVISIONS
City of Ft COl11ns,CSU the Board of Governors of the Colorado State
University system and The State of Colorado shall be named as Additional
Insureds on each commercial General Liability policy per form G123127A
attached
CERTIFICATE HOLDER
STCODE2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL *30 DAYS WRITTEN
City Of Ft Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL
PO BOX 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY MIND UPON THE INSURER ITS AGENTS OR
Ft Collins CO 80522 REPRESENTATIVES
From a+ IA u B 27 2004 1 3 4 4 P M" and OISOn Ltd To Terl Brulnama
LNo 2321 DOa P 2/31 Pa9E 2Of4
ACORD CERTIFICATE OF LIABILITY INSURANCE OF ID DATE(MMIDbtYrM
vrtobucEX COOVE-1 08/24 04
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Olson 6 Olson Ltd ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR
P O Box 1467 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Englewood CO BO150
Phone 303-761-0085 Fax 303-708-1917
IN8URE0
INSURERS AFFORDING COVERAGE NAIL#
Zurich ATDeriCaA Insurance
(PLB)*over-Clark
& As ociates F C 55 Sherman St , 1205
Deaver CO 80203
E__
C[]VFRAl�FS
_.
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN 188UED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING
ANY REWIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RE5PECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAYPERTAIN THE INSURANCEAFFORDED SYTHE POLICIES DE6(.RI8ED HEREIN ISSUBJECTTO
POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BFFN REDUCED BY PAID CLAIMS
ALL IHb TERM5 EXCLU1I1NBANOCONOITCN6OFSUCH
LTRrMAL
TYPEINSURAHCE
FOLICYNIURNER
DATE N
DATE MMbO/YY
LIMBS
EACHOCCUtPENCE
i
GENERAL LIABILITYPREMISES(Ea
ocew oADE
OCCI,R
i
MED FXP (MY One Pere
---PERSONAL
6ADv INJLWYGENEPALAGGRSGATE
{
LIMIT APPLIES PERpp
PRODUCTS COMPIOPAGGWT
LOC
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Poo cEenl)
i
ALL OVNVED AUTOS
BODILY INJURY
(Pe pe-son)
i
SCHEDULED AUTOS
HIRED AUTOS
BODILY INJURY
(Pe eccleeN)
$
NON -OWNED AUTOS
a
PROPERTY DAMAGE
(Pe, ecm{enl)
{
1EXCENIVU114MR91-1-A
AUTO OILY EAACCIDENT
{
OTHER THAN EA ACC
$
AUTO ONLY AOG
$
YEACH
EA�O
.IM6 MADE
OCCURRENCE
$
AGGREDA7E
T
WORKERS COMPENSATION AND
$
EMPLOYERS LIABILITY
TORYLIMITS ER
ANY PROPRIETORPARTNERiBXECVnvE
OFFlCER/MEMRER EXCLUDEDi
EL EACH ACCIDENT
$
If yye describe Unees
SPECIPL PROVISION6 belvv
EL DISEASE EA EMPLOYEE
OTHER
E L DISEASE POLICY LIMB
{
A Proressa.onal EOC 9305791 02
OB/15/04 00/15/05 Per
Liability CLATMR MAOE
elm
1 OOp OOD
DESCRIPRO CF OPBRA 5I LOCATIONS/ IIHICLESI EXCLUSIONS A00EDSYENppRSEME
*Except ZOr
A re ate
AePECIALPROWS10N9 g
1,000 QOO
non-payAwnt of premluin Par Clamor" and Annual Aggregate
limits apply to all projects Payment of claims defense coats and claim
expanses reduce the limits
CERTIFICATE HOLDER
CYPTCOL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TIE=EXPIRAWN
DATE THEREOF THEMSUIND INBVRERWILL ENDEAVORTOMAIL •30 DAYa VYRDTEN
city or Ft Collins NOTICE TO THE CERTIPIOATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO 90&MLL
P O BOX 590 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINO UPON THE INSURER RE AGENTS OR
tort Collins CO 80522 REPRESENTAmE&
THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY
ARCHITECTS & ENGINEERS
BLANKET ADDITIONAL INSURED ENDORSEMENT
BLANKET WAIVER OF SUBROGATION ENDORSEMENT
This endorsement modifies Insurance provided under the following
BUSINESS ACCOUNT PACKAGE POLICY BUSINESS LIABILITY COVERAGE FORM
BUSINESS ACCOUNT PACKAGE POLICY BUSINESSOWNERS COMMON POLICY CONDITIONS
WHO IS AN INSURED (Section C) of the
Business Liability Coverage Form is amended to
include as an insured any person or organization
(called additional insured) whom you are required
to add as an additional Insured on this policy
under
1 A written contract or agreement or
An oral agreement or contract where a
certificate of Insurance showing that person
or organization as an additional insured has
been issued but
the written or oral contract or agreement
must be
a currently in effect or becoming effective
during the term of this policy and
executed prior to the bodily injury
property damage personal injury or
advertising injury
The insurance provided to the additional insured
is limited as follows
That person or organization is only an
additional insured with respect to liability
arising out of
a Premises you own rent lease or
occupy or
Your ongoing operations for that
additional insured by or for you
The insurance provided to the additional
insured does not apply to bodily injury or
property damage included within the
products completed operations hazard
2 The Limits of Insurance applicable to the
additional insured are those specified in the
written contract or agreement or in the
Declarations for this policy whichever are
less These Limits of Insurance are
included within and not in addition to the
G 123127 A
(Ed 12/96)
Limits of Insurance shown in the
Declarations
A persons or organizations status as an
additional Insured under this endorsement
ends when your operations for that
additional insured are completed
The insurance provided to the additional insured
does not apply to bodily Injury property
damage personal injury or advertising injury
arising out of an architects engineers or
surveyors rendering of or failure to render any
professional services including
The preparing approving or failing tc
prepare or approve maps drawings
opinions reports surveys change orders
design or specifications and
2 Supervisory inspection or engineering
services
Any coverage provided hereunder shall be
excess over any other valid and collectible
insurance available to the additional insured
whether primary excess contingent or on any
other basis unless a written contract specifically
requires that this insurance be primary
Paragraph 2 of Section J TRANSFER OF
RIGHTS OF RECOVERY AGAINST OTHERS
TO US of the Businessowners Common Policy
Conditions form is deleted and replaced by the
following
Applicable to The Business Account
Package Policy Liability Coverage
We waive any right of recovery we may
have against any person or organization
against whom you have agreed to waive
such right of recovery in a written contract
or agreement because of payments we
make for injury or damage arising out of
your ongoing operations or your work
done under a contract with that person or
organization and included within the
products completed operations hazard