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HomeMy WebLinkAbout112468 FELSBURG HOLT & ULLEVIG INC - INSURANCE CERTIFICATE (5)ACORD�, CERTIFICATE OF LIABILITY INSURANCE 0DATE 6/22/09Dnv) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Van Gilder Insurance Corp. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1515 Wynkoop, Suite 200 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Denver, CO 80202 303 837-8500 INSURERS AFFORDING COVERAGE INSURED INSURER A: Travelers Indemnity Company 6300 Felsburg Holt & Ullevig, Inc. INSURER B: The Phoenix Ins. Co (SPT) Cent S. Syracuse Way, #600 INSURER c: Hartford Accident & Indemnity Centennial, CO 80111 INSURER D: XL Specialty Insurance Company INSURER E: '0(01rI7:7•Tl13--+ 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. NSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR 68022781-711 06/21/09 06/21/10 EACH OCCURRENCE $1,000,000 FIRE DAMAGE (Any one fire) $1,000,000 MED EXP (Any one person) $10 000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: POLICY PRO LOC JECT PRODUCTS - COMP/OP AGG $2 000 000 B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BA300SL260 06/21/09 06/21/10 COMBINED SINGLE LIMIT (Ea 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 EA ACC AUTO ONLY: AGG $ $ A EXCESS LIABILITY X1 OCCUR CLAIMS MADE DEDUCTIBLE X RETENTION $10000 CUP6540Y22A 06/21/09 06/21/10 EACH OCCURRENCE s4,000,000 AGGREGATE $4100%000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 34WEGPP3731 06/21/09 06/21/10 X WC STATU- OTH- T RY LIMIT E E.L. EACH ACCIDENT $1,000 000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 d OTHER Professional Liability Claims Made DPR9619054 06/21/09 06/21/10 $2,000,000 per claim $5,000,000 annl aggr. DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS *Except 10 days notice for non-payment of premium 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 (See Attached Descriptions) \Ir_n 11rIVA 1 C nuL.Uan I I AUUIIIUNAL INSURED; INSURER LETTER: _ GAINULLLA I IUN City of Fort Collins Attn: James B. O'Neill II, CPPO, FNIGP 215 North Mason Street, 2nd Floor Fort Collins, CO 80524 SHOULD ANY OF TH E ABOVE D ESCRIB E D POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL30* DAYS WRITTEN NOTICETOTHE CERTIFICATE HOLDER NAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL IMPOSE NOOBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURE R,ITS AGENTS OR A HORIZED REPRESENTATIV -" . . �\)ou"I, AGUMU zo-s (nai)1 of 3 #M569035 MQG © 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. AUUHU 25-5 (1ie1)2 O t 3 #M5 6 9 U 3 5 with respect to the above referenced. *Except 10 days notice for non-payment of premium. HIVIb zo.a (UflUf) 3 OT 3 SMbbyUSb