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HomeMy WebLinkAbout111694 TST INC CONSULTING ENGINEERING - INSURANCE CERTIFICATE (3)Client#: 10439
TSTCON
O
ACRD,M CERTIFICATE
OF LIABILITY
INSURANCE
12111/080nv)
PRODUCER
THIS CERTIFICATE
IS ISSUED AS A MATTER OF INFORMATION
Van Gilder Insurance Corp.
700 Broadway, Suite 1000
ONLY
HOLDER.
ALTER
AND CONFERS NO RIGHTS UPON THE CERTIFICATE
THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver, CO 80203
—
303 837-8500
INSURERS AFFORDING COVERAGE
INSURED
TST, Inc. Consulting Engineers
748 Whalers Way
Fort Collins, CO 80525
INSURER A:
Hartford Casualty Insurance Cc
INSURER B:
Hartford Underwriters Insurance Co
INSURER c:
Hartford Ins. Co. of the MidWest
INSURER D:
XL Specialty Insurance Company
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
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMID DM'
POLICY EXPIRATION
DATE MMIDONV
LIMITS
A
GENERALLIABILITY
X COMM ERCIAL GENERAL LIAR LITY
CLAIMS MADE n OCCUR
34SBAVS3417
12/01/08
12/01/09
EACH OCCURRENCE
$1000,000
FIRE DAMAGE (Any one fire)
$300000
MED ENE (Any one person)
$19,990
PERSONAL &ADV INJURY
Al 000,000
GENERAL AGGREGATE
$2 000 000
GEN'L AGGREGATE LIMITAPPILIES PER:
PRO-
POLICY JECT LOG
PRODUCTS - COMPIOP AGG
$2,000,000
._._..._
_
B
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
34UECP02033
12/01/08
12/01/09
COMBINED SINGLE LIMIT
Be accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
—
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EAACC
AUTO ONLY: AGO
$
$
EXCESS LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
$_
_
$
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
34WEGIO8204
12/01/08
12/01/09
X WC STATU-
E.L. EACH ACCIDENT
$110001000
E.L. DISEASE -EA EMPLOYEE
$1,000,000
E.L. DISEASE -POLICY LIMIT
$1,000,000
D
OTHER Professional
Liability
Claims Made
DPR9616004
12/01/08
12/01/09
$1,000,000 per claim
$1,000,000 annl aggr.
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
*Except 10 days notice for non-paynent of premium.
City of Fort Collins
Attn: James B. O'Neill II
281 N. College Avenue
Fort Collins, CO 80524
SHOULD ANYOF TH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TH E EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL36*___ DAYS WRITTEN
NOTICE TOTHE CERn FICATE HOLDER NAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURERJTS AGENTS OR
A HORIZED REPRESENTATIV
ACORD 25-S (7I97)1 of 2 #S555312/M555099 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 2 ##S555312/M555099