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HomeMy WebLinkAbout330179 INTERWEST CONSULTING GROUP - INSURANCE CERTIFICATE (5)Client#: 46759 INTCON6 ACORD„, CERTIFICATE OF LIABILITY INSURANCE 11/12/080Yv) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Van Gilder Insurance Corp. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 700 Broadway, Suite 1000 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Denver, CO 80203 303 8374500 INSURERS AFFORDING COVERAGE -- -- INSURED INSURER A. ..—.—___ - Travelers Insurance (Med/A&E) Interwest Consulting Group INSURER e . —_ - ce Co -- - -- - XL Specialty Insurance Company 1076 Lincoln Place Boulder, CO 80302 INSURER C INSURER D: INSURER E: COVERAGES 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 POLICY EFFECTIVE POLICY EXPIRATION TYPE OF INSURANCE POLICY NUMBER - LTR DATE MMIDO/YY DATE MMIDDM/ LIMITS A GENERAL LIABILITY 6807444M622 11/14/08 11/14/09 EACH OCCURRENCE $2 000 000- X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any one fire ) _ $1,000000 CLAIMS MADE X OCCUR . MED EXP(Anyone person) $10,000_.. PERSONAL&ADVINJURV $2000,-900 _ GENERAL AGGREGATE $4�000,000 GENT AGGREGATE LIM ITAPPL IES PER: PRODUCTS COMPIOPAGG $4000,000 POLICY PRO- LOG JECT --_--�_--- A AUTOMOBILE LIABILITY BA7466M429 11/14/08 11/14/09 COMBINED SINGLE LIMIT $ 1,000,000 X ANY AUTO (Ea accident) At L OWNED AUTOS BODILY INJURY $ -- SCHEDULED AUTOS Per person) X HIREDAUTOS ----- BODILY INJURY $ X NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GELIABILITY AUTO ONLY - EA ACCIDENT ---_- - _-�- $ NY AUTO OTHER THANAUTO +AEXCESS ONLY: AGG LIABILITY CUP133OT362 11/14/08 11/14/09 EACH OCCURRENCE $1,000000 rCCUR CLAIMS MADE AGGREGATE $1,000 OOO DEDUCTIBLE X RE(ENTION $1 O 000 $ A WORKERS COMPENSATION AND UB1339T934 11/14/08 11/14/09 WC S7AN OTII X ORY_LIM11S EMPLOYERS' LIABILITY ER E.L. EACH ACCIDENT $1,000,000 E L DISEASE EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 B OTHER Professional DPR9607493 11/14/08 11/14/09 $1,000,000 per claim Liability $3,000,000 anni aggr. laims Made DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS *Except 10 days notice for non-payment of premium. City of Fort Collins Attn: James B. O'Neill 281 N. College Avenue Fort Collins, CO 80521 SHOULD ANVOF TH E ABOVE D ESCRIBED POLICIES BE CANCELLED B EFORE TH E EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O*_- DAYS W RITTEN NOTICE TOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, BUTFAILURE TO DOSOSHALL IMPOSE NO OBLIGATION OR LIABILITYOF ANYKIND UPON TH E INSURERJTS AGENTS OR A ORIZED REPRESENTATIVE ". '. .-o vr.117 or z 4111.1553376 CDyy © ACORD CORPORATION 1988 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. na.vw'o-o tunrlL OL 2 TTMbbd.S/b Client#: 46759 INTCON13 ACORD„, CERTIFICATE OF LIABILITY INSURANCE M/DDYV) 11121 11/72/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Van Gilder Insurance Corp. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 700 Broadway, Suite 1000 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Denver, CO 80203 303 837-8500 INSURERS AFFORDING COVERAGE INSURER A: Travelers Insurance Mod/A&E) Interwest Consulting Group — — INSURERS —__ -_ -- XL Specialty Insurance Company 1076 Lincoln Place Boulder, CO 80302 INSURER - INSURER D: INSURER E: COVERAGES 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 POLICY EFFECTIVE POLICY EXPIRATION LTft TYPE OF INSURANCE POLICY NUMBER DATE 12MMIOD/YY DATE MMIDOM/ LIMITS A GENERAL LIABILITY 6807444M622 11/14/08 11/14/09 EACH OCCURRENCE $2,000000 X COMMERCIAL GENERAL LIABILITY FIRE DAM (Any one nre) $1,0�000 -AGE CLAIMS MADE L 4_ OCCUR MED EXP (Any one person) $10,000_ PERSONAL &ADV INJURY, $2,000,O000 GENERAL AGGREGATE $4,0001000 GEN'L AGGREGATE LIMIT APPL IES PER: PRODUCTS COMPIOPAGG $4000,000 PRO- El POLICY JECT LOC A AUTOMOBILE LIABILITY BA7466M429 11/14/08 11/14/09 ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X ALL OWNED AUTOS BODILY INJURY -- SCHEDULED AUTOS (Per person) $ X HIRED AUTOS SOINJURY X NON -OWNED AUTOS accident) (Perr accident) $ PROPERTY DAMAGE $ (Per accident) - GARAGE LIABILITY AUTO ONLY -EA ACCIDENT $ --__ ANY AUTO OTHER THAN EAACC $_ AUTO ONLY: AGO $ A EXCESS LIABILITY CUP1330T362 11/14/08 11/14/09 EACH OCCURRENCE $_1,000,000 X- OCCUR 1 CLAIMS MADE - _ AGGREGATE , - $1�000,000 $ DEDUCTIBLE X RETENTION $1 O 000 $ A WORKERS COMPENSAHON AND U131339T934 11/14108 11/14M9 ��W�.sT;ru- oTH. 1'QRY.LIMITS._I_____EB_.__._.__..___.._—.______ -- EMPLOYERS' LIABILITY __ E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE-EAEMPL OYEF. $1,000,000 ELDISEASE-POLICYLIMIT $1,000,000 B OTHER Professional DPR9607493 11/14/08 11/14/09 $1,000,000 per claim Liability $3,000,000 annl aggr. laims Made DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS *Except 10 days notice for non-payment of premium. Re: Horsetooth & Ziegler Project As required by written contract or written agreement, the Certificate Holder is included as Additional Insured under General Liability with respect to the above referenced. (See Attached Descriptions) City of Ft. Collins Attn: James B. O'Neill P.O. Box 5801 Fort Collins, CO 80522 SHOULD ANYOFTHE ABOVE DESCRIBED POLICIESBE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL30�__. DAYSWRITTEN NOTICE TOTHE CERTIFICATE HOLDER NAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL IMPOSE NO OBLIGATION OR LIABILITYOF ANY KIND UPON THE INSURER,ITS AGENTS OR At:ORIZED REFIRE Aa Umu co -a (naT)1 of 3 #M553376 CDW ©ACORD 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. ACORD25-S(7/97)2 of 3 #M553376 DESCRIPTIONS (Continued from Page 1) AMS 25.3 (07197) 3 of 3 #M553376