HomeMy WebLinkAbout296701 TIBURON / COMPUDYNE - INSURANCE CERTIFICATE (3)ACORD„A CERTIFICATE
OF LIABILITY INSURANCE
DATE (MMIOD/YYYY)
9/4/2008
PRODUCER (415) 874-7100 FAX: (415) 874-7199
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Equity Rik Partners, Inc.
1' sar
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
License No. OD21146
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
101 Montgomery Street, 14th Fl
San Francisco CA 94104
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURERA:ACE American Insurance
22667
INSURERB National Union Fire Ins.
19445
Tiburon, Inc.
6200 Stoneridge Mall Road
INSURER c: Wes tches ter Fire
21121
INSURERUIns. Co. of the State of
19429
Suite 400
Pleasanton CA 94588
INSURER E:
OVERAGES
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
ADD'L
p
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIDD/YY
POLICY EXPIRATION
DATE MMIDDNY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
DAMAGE
PREMISSS EEa
Ea occurrence)
$ 1,000,000
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
G23866791
9/l/2008
9/1/2009
MED EXP (Any oneperson)
$ Excluded
PERSONAL ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2,000,000
RI- X LOC
17 POLICY IECT
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$ 11000,000
X
BODILY INJURY
(Per person)
$
B
ALL OWNED AUTOS
SCHEDULED AUTOS
CA4576404
9/l/2008
9/l/2009
X
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
X
X
PROPERTY DAMAGE
(Per accident)
$
Comp Deductible-$250
X1
Coll Deductible-$500
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHERTHAN EA ACC
S
ANY AUTO
$
AUTO ONLY: AGG
EXCESSIUMBRELLA LIABILITY
X OCCUR CLAIMS MADE
EA H E
$ 10,000,000
AGGREGATE
$ 10,000,000
$
G22056141001
9/l/2008
9/1/2009
$
C
DEDUCTIBLE
Is
X RETENTION S 10,000
1
D
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNERIEXECUTIVE
No one excluded from EL
OR 4883930
T ATU-
WCV MITST91
X I
E.L. EACH ACCIDENT
S 1,000,000
E.L. DISEASE - EA EMPLOYEE$
1,000,000
B
OFFICERJMEMBER EXCLUDED?
If yes, describe under
CA 4883929
9/l/2008
9/1/2009
E.L. DISEASE -POLICY LIMIT
$ 1,000,000
SPECIAL PROVISIONS below
AOS 4883928
OTHER
Limit 3,000,000
B
Errors & Omissions
012116119
9/1/2008
9/1/2009
Retention 250,000
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
THE CITY AND COUNTY, THEIR OFFICERS, OFFICIALS, EMPLOYEES, AGENTS, AND VOLUNTEERS ARE INCLUDED AS ADDITIONAL INSUREDS
AS RESPECTS WORT( PERFORMED BY OR ON BEHALF OF THE NAMED INSURED.
CITY CLERK'S OFFICE
300 LAPORTE AVENUE
P.O. BOX 580
FORT COLLIN, CO 80522-0580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
FAILURE TO DO 50 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
%CORD
INS025 (DiDe).oea
AUTHORIZED
Marcon/'PHOMP
,7 ACOR❑
Page 1 of 2
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
insurer(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.
... MU co kcuu I/U0)
INS02510 Bp8a Page 2 of