HomeMy WebLinkAboutFELBURG HOLT AND ULLEVIG - INSURANCE CERTIFICATEAr-e-) D.. CERTIFICATE OF LIABILITY INSURANCE 1DATE (MMID
2102/2/02108D/YY)
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
Denver, CO 80203 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
303 837-8500 INSURERS AFFORDING COVERAGE
----- -----------_. — --- ---
INSURED INSURER A' T ravelersl n demnity Company
Felsburg Holt & Ullevig, Inc. -- -- I -- --
6300 S. Syracuse Way, #600 INSURER B. The Phoenix Ins.Co (SPT)
Centennial, CO 80111 INSURERc: Hartford Accident & Indemnity
---_.---------------
INSURER XL SDecialty Insurance Comnanv
INSURER E:
l UVtKAl9t6
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
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIDDM'
POLICY EXPIRATION
DATE MMIDD/Y1'
LIMITS
A
GENERAL
LIABILITY
68022781_711
06/21/08
06/21/09
EACH OCCURRENCE
$11000�000
X
COMM ERCIAL GENERAL L IAB ILLY
___
FIRE DAMAGE (Any one fire
$1 0001Q0O
CLAIMS MADE r`' OCCUR
_)
�I
MED EXP (Any one person)_
_
$5 000
PERSONAL &ADV INJURY
$1,0000
GENERALA_GGREGATE
GEN'LAGGREG_ATELIMITAPPLIESPER:
PRODUCTS -COMP/OPAGG
.--...-. ___..___—
_$_200000_0__—
$2,000,000-
.
_
POLICY PR0 —,'._ LOC_
B
AUTOMOBILE
LIABILITY
BA3008L260
06/21/08
06/21/09
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
ALL OWNED AUTOS
— -
BODILY INJURY
$
SCHEDULED AUTOS
(Per person)
HIRED AUTOS
_X
X
BODILY INJURY
$
NON -OWNED AUTOS
(Per accident)
DAMAGE
$
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
--
OTHER THAN EA ACC
$
AUTO ONLY: AGG
$
A
EXCESS LIABILITY _
CUP6540Y22A
06/21/08
66/21/09
,EACH OCCURRENCE
.,$4,000000
OCCUR L� CLAIMS MADE
AGGREGATE
$4,000 000
DEDUCTIBLE
X RETENTION $10000
$
C
WORKERS
S COMPENSATION AND
34WEGPP3731
O6/21/OS
O6/21/09
WC STATU- L OTH
X�T
LIABILITY
T48Y.LIMLT_5_ —_ �(;__
E_.___._._...__
L.EACHACCIDENT
$1,0OQ000
E.L. DISEASE -EA EMPL OYEE
$1,000,000
E.L. DISEASE _POLICY LIMIT
$1,000,000_
D
OTHER Professional
DPR9612662
06/21/08
06/21/09
_
$2,000,000 per claim
Liability
$5,000,000 annl aggr.
laims Made
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE: Fort Collins Quiet Zone Study
If required by written contract or written agreement, City of Fort Collins
is included as Additional Insured for ongoing operations under General Liability
with respect to the above referenced.
*Except 10 days notice for non-payment of premium.
City of Fort Collins
Attn: James B. O'Neill II, CPPO, FNIGP
215 North Mason Street
2nd Floor
Fort Collins, CO 80524
SHOULD ANYOF TH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TH E EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL30____ DAYS WRITTEN
NOTICE TOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL
IM POSE NO OBLIGATION OR LIABILITY OF ANYKIND UPON TH E INSURERJTS AGENTS OR
A HORIZED REPRESENTAT
�,-. V'o, IT Or SJD04b4b/Mb3U4U7 MQG 0 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.
AGORD25-S(7/97)2 of 2 #S554546/M536407