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Home My WebLink About451613 EMPLOYERS EDGE LLC - INSURANCE CERTIFICATEACOM CERTIFICATE OF LIABILITY INSURANCE 10/09/2009 PRODUCER (303)322-0800 FAX Madison Insurance Group 42S South Cherry St Ste #420 Denver CO 80246-1231 INSURED 138S S COLORADO BLVD #A322 DENVER, CO 80222 A MATTER OF INFORMATION UPON THE CERTIFICATE S NOT AMEND EXTEND OR INSURERS AFFORDING COVERAGE INSURER Hartford Casualty INSURERS Sentinel Insurance INSURER Philadelphia Insur INSURER D INSURER E NAIC # 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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE flkffik� LIMBS A GENERAL LIANLRY X COMMERCIAL GENERAL LIABILITY CLAIMS WOE [X OCCUR 34SBARV1642 06/01/2008 06/01/2009 EACHOCCURRENCE $ 1 000.000 DAMAGE TO RENTED $ 300,00 $ 10 QQ MED EXP (Any one person) PERSONAL $ ADV INJURY $ 1 000,000 GENERAL AGGREGATE $ 2 QQQ QQ GEN L AGGREGATE LIMIT APPLIES PER X POLICY JECT LOC PRODUCTS COMP/OPAGG $ 2 000 QQ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS COMBINED SINGLE LIMIT (Ea amtlent) $ BODILY INJURY (Per person) $ BODILY INJURY (Per amdent) $ PROPERTY DAMAGE (Per..went) $ GARAGE LIABILITY ANY AUTO q AUTOONLY EAACCIDENT $ OTHER THAN EA ACC AUTO ONLY AGO $ $ E%CESS/UMBRELLA LIABILITY OCCUR F_ICLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE $ $ B WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNEWEXECUTIVE OFFICER/MEMBER EXCLUDED If Syas describe under SP ECPROVISIONS below 34WECRCS421 06/01/2008 06/01/2009 X I WCSTATU I I OTH E L EACH ACCIDENT $ 100,000 EL DISEASE EA EMPLOYEE $ 100QQ E L DISEASE POLICY LIMIT $ 500,00 C roYesslonal Liability (Claims made policy) PHSD330243 06/01/2008 06/01/2009 $1 000,000 per claim $1 000 000 General Aggregate DESCRIPTION OF OPERATIONS / LOCATONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS le Except 10 days notice of cancellation for non-payment of premium City of Ft Collins Purchasing Division Attn Ed Bonnette 215 N Mason, 2nd Floor Ft Collins, CO 8OS22 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 MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY WND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIVE .V.. LD LLYu I/VOJ CACORD CORPORATION 1988 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 AUUMIJ 20 (ZuuuuS)