HomeMy WebLinkAboutTHE NEENAN COMPANY - INSURANCE CERTIFICATE (12)ACORDou CERTIFICATE OF LIABILITY INSURANCE ,nizo,o DAT12/17/2008)
PRODUCER Lockton Companies, LLC Denver THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
8110 E Union Avenue ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Suite700 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Denver 80237 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
(303) 414-6000 INSURERS AFFORDING COVERAGE I NAIC #
INSURED The Neenan Company LLLP
1060993 2620 E. Prospect Road, Suite 4100
Fort Collins, CO 80525
I INSURERB NATIONAL UNION FIRE I I
I INSURER D: Steadfast Insurance Co. I I
COVFPAnFA NEF.0001 TH THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWI7HSTANDIM
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
ADDT
INSRD
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE IMMIDD/YYI
POLICY EXPIRATION
DATE (MMIDDIYY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000 000
A
X COMMERCIAL GENERAL LIABILITY
GL0427719404
1/1/2009
1/1/2010
DAMAGE TO RENTED
PRE ISE$ a eccurence
_
$ 300,000
MED EXP (Any one person)
_
$ 10,000
CLAIMS MADE a OCCUR
PERSONAL & AOV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGO
$ 2,000,000
PRO-
POLICV X JECT LOC
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
BAP427719504
1/1/2009
1/1/2010
COMBINED SINGLE LIMIT
(Ea accident)
$ ],000,OOO
BODILY INJURY
(Per person)
$ XXXXXXX
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Per accident)
$ XXXXXXX
HIREDAUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE
(Per accident)
S XXXXXXX
GARAGE LIABILITY
ANY AUTO
NOTAPPLICABLB
AUTO ONLY - EA ACCIDENT
$ XXXXXXX
OTHER THAN EAACC
$ XXXXXXX
AUTO ONLY. AGO
$ XXXXXXX
H
EXCESS/UMBRELLA
X
LIABILITY
OCCUR CLAIMS MADE
B1c7275128
I/1/2009
1/1/2010
EACH OCCURRENCE
$ 10,000,000
AGGREGATE
S 10,000,000
$ XXXXXXX
a UMBRELLA
S XXXXXXX
DEDUCTIBLE FORM
$ XXXXXXX
RETENTION $
WORKERS COMPENSATION AND
4025258
1/1/2009
1/1/2010
X WCSTATU- OTH-
11t
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$ 1,000,000
E.L.DISEASE - EA EMPLOYEE
$ I,000,000
OFFCERIMEMBER EXCLUDED?
ff,,,desanhemder
SPECIAL PROVISIONS our., NO
E. L. DISEASE -POLICY LIMIT
S 11000000
OTHER
D
Professional
F00534253304
1/1/2009
I/1/2010
Limie$5,000,000
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
RE: 111886 Police Services facility. Cil , of Fort Collins, Fort Collins Capital Leasing Cor>oralion, Fort Collins Police Services Facility, 2221 South
Timberline Rd, Ft Collins, 80525, and lJS Bank National Association are included as AdZional Insured as respects General & Auto Liability, If i I
11�. r r r SHOULD ANY OF THE ABOVE DESCRIBED POLICIES
��.Bt�yE,,NCANCELLED BEFORE THE EXPIRATION
City of Fort Collins DATE THEREOF, THE ISSUING INSURER WILL 6 pY%XC*)TA MAIL 30 DAYS WRITTEN
Attn: Jim O'Neill, Purchasing Division NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,)(tXXAUft)tXP:(X$)6Dt IX
PO Box 580 yMrDSXX k&3 GRpKh9XKXi3 [DYY[9EX4TGYt3Nr4A90NXHExN6ttiE hTXX NrisX9C
Fort Collins, CO 80522
AUTHORIZED REPRES T E
we 4
ACORD 25(2001/08) For questions regarding this certificate. contest the nutnoe,Mea in the'Producoe section ai endsP.riryae orient code•NEEeo%'. ACORD CORPORATION 1AAS
No Text
Additional Insured - Automatic - Owners, Lessees Or
Contractors - Broad Form
Policy Nn. Eff. Date of Pol Ex . Date of Pol. Eff. Date of End. Producer Add'L Prem Retum Prem.
GL0427719404 01/01/2009 01/01/2010 01/01/2009 LOCRTON Included N/A
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ rr CAREFULLY.
This endorsement modifies insurance provided under the:
Commercial General Liability Coverage Part
A WHO IS AN INSURED (Section H) is amended to include as an insured any person or organization whom you are re-
quired to add as an additional insured on this policy under a written contract or written agreement
B The insurance provided to additional insureds applies only to 'bodily injury, "property damage" or "personal and adver-
tising injury" covered under Section L Coverage A, BODILY INJURY AND PROPERTY DAMAGE LIABILITY and
Coverage B, PERSONAL AND ADVERTISING INJURY LIABILITY, but only if:
1. The "bodily injur/ or "property damage" results from your negligence; and
2. The 'bodily injury', "property damage" or "personal and advertising injur/ results directly from:
a. Your ongoing operations; or
b. "Your work" completed as included in the "products -completed operations bazmd",
performed for the additional insured, which is the subject of the written contract or written agreement
C. However, regardless of the provisions of paragraphs A and B. above:
L We will not extend any insurance coverage to any additional insured person or organization
a. That is not provided to you in this policy; or
b. That is any broader coverage than you are required to provide to the additional insured person or organization
in the written contract or written agreement; and
2. We will not provide Limits of Insurance to any additional insured person or organization that exceed the lower of:
a. The Limits of Insurance provided to you in this policy; or
b. The Limits of Insurance you are required to provide in the written contract or written agreement.
D. The insurance provided to the additional insured person or organization does not apply to:
1. 'Bodily injury', "property damage" or "personal and advertising injury' that results solely from negligence of the ad-
ditional insured; or
U-GL-WS-A CW (9/03)
Page t or 3
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
AGENT COPY
2. "Bodily injury', "property da...ge" or "personal and advertising injury" arisL_ jut of the rendering or failure to
render any professional architectural, engineering or surveying services including:
a. The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys,
field orders, change orders or drawings and specifications; and
b. Supervisory, inspection, architectural or engineering activities.
E. The additional insured must see to it that:
1. We are notified as soon as practicable of an "occurrence" or offense that may result in a claim:
2. We receive written notice of a claim or "suit" as soon as practicable; and
3. A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by
another insurer under which the additional insured also has rights as an insured or additional insured.
F. The insurance provided by this endorsement is primary insurance and we will not seek contribution from any other
insurance available to any additional insured person or organization unless the other insurance is provided by a con-
tractor other than you for the same operations and job location. Then we will share with that other insurance by the
method described in paragraph 4.c. of SECTION IV • COMMERCIAL GENERAL LLIBILM CONDMONS.
Any provisions in this Coverage Part not changed by the terms and conditions of this endorsement continue to apply as
written.
U41,1175•A CW (9/03)
Page 3 of I
AGEW COPY
POLICY NUMBER: BAP 4277195-04
COMMERCIAL AUTO
CA 20 0103 06
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
LESSOR - ADDITIONAL INSURED AND LOSS PAYEE
This endorsement modes insurance provided under the following: .
BUSINESS AUTO COVERAGE FORM
BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM
GARAGE COVERAGE FORM.
MOTOR CARRIER COVERAGE FORM
TRUCKERS COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi-
fied by the endorsement
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated
below.
Insured:
Date:
Signature:
SCHEDULE
r
om aner:ate:red:
Additional Insured (Lessor): ALL LESSORS
Address:
Designation Or Description Of "Leased Autos": ALL LEASED AUTOS
Covers es
Limit Of lnsuranca
Liabili
$ 1 000 000 Each "Accident"
Actual Cash Value Or Cost Of Repair Whichever Is Less, Minus
Comprehensive
$ SEE SCHEDULE Deductible For Each Covered "Leased Auto"
Actual Cash Value Or Cost Of Repair Whichever Is Less, Minus
Collision
$ SEE SCHEDULE Deductible For Each Covered "Leased Auto"
Specified
Actual Cash Value Or Cost Of Repair Whichever Is Less, Minus .
"Leased
Causes Of Loss
S Deductible For Each Covered Auto"
Information wired to com fete this Schedule I not shown above will be shown in the Declarations.
A. Coverage "o"auto" you own and not a covered "autyou
hire or borrow.
1. Any "leased auto" designated or described in
the Schedule will be considered a covered
CA 20 01 03 06 Copyright, ISO Properties, Inc., 2005 Page 1 of 2
UNIFORM
.2. For a 'leased auto" designated or described in
the Schedule, Who Is An Insured is changed
to include as an insured" the lessor named in
the Schedule. However, the lessor is an ..in-
sured" only for "bodily injury' or "property
damage" resulting from the acts or omissions
by:
a. You;
b. Any of your "employees" or agents; or
c. Any person, except the lessor or any
"employee" or agent_ of the lessor, oper-
ating a "leased auto" with the permission
of any of the above.
3. The coverages provided under this endorse-
ment apply to any 'leased auto" described in
the Schedule until the expiration date shown
in the Schedule, or when the lessor or his or
her agent takes possession of the "leased
auto", whichever occurs first.
B. Loss Payable Clause
1. We will pay, as interest may appear, you and
the lessor named in this endorsement for
"loss" to.a "leased auto".
2. .The insurance covers the interest of the les-
sor unless the 'loss" results from fraudulent
acts or omissions on your part.
3. If we make any payment to the lessor, we will
obtain his or her rights against any other
party.
C. Cancellation
1. If we cancel the policy, we will mail notice to
the lessor in accordance with the Cancellation
Common, Policy Condition.
2.. If you cancel the policy, we will mail notice to
the lessor.
3. Cancellation ends this agreement
D. The lessor is not liable for payment of your premi-
ums,
E. Additional Definition .
As used in this endorsement:
"Leased auto" means an "auto" leased or rented
to you, including any substitute, replacement or
extra "auto" needed to meet seasonal or other
needs, under a leasing or rental agreement that
requires you to provide direct primary insurance
for the lessor.
Page 2 of 2 Copyright, ISO Properties, Inc., 2005 CA 20 01 03 66
P1NNACOL
ASSURANCE
7501 E Lowry Blvd
Denver, CO 80230-7006
Phone: (303) 361-40001 (800) 873-7242
Fax: (303) 361-50001(888) 329.2251
NCCI #: WC000313B
Policy #: 4025258
INSURED: AGENT:
NEENAN EMPLOYEES HOLDING COMPANY INC LOCKTON COMPANIES OF COLORADO, INC.
ATTN: RYAN DELLOS - ACCOUNTING 8110 E. UNION AVE., SUITE 700
2620 E PROSPECT RD. STE 100 DENVER, CO 80237-2984
FORT COLLINS CO 80525 (303) 414-6000
ENDORSEMENT: Blanket Waiver of Subrogation
We have the right to recover our payments from anyone liable for any injury covered by this policy. We will not
enforce our right against the person or organization named in the schedule. This agreement applies only to the
extent that you perform work under a written contract that requires you to obtain this agreement from us.
This agreement shall not operate directly or indirectly to benefit anyone not named in the schedule.
SCHEDULE
To any person or organization when agreed to under a written contract or agreement, as defined
above and with the insured, which is in effect and executed prior to any loss.
Effective Date: January 1, 2009 Expires on January 1, 2010
Pinnacol Assurance has issued this endorsement December 16, 2008.
Sarah Bensman
Underwriter
Pinnacol Assurance' 7501 E Lowry Blvd * Denver, CO 80230
Page 1 of 1 BENSMANS Undervrtlier 121161200818:32:58 4025258 Updated 05/0912007 359 8
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