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HomeMy WebLinkAboutHANDH DATA - INSURANCE CERTIFICATEACORD,. CERTIFICATE OF LIABILITY INSURANCE OP ID VM— DATE (MMIDD/YYYY) HHELE-1 07 21 09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION GNLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Front Range Insurance Group HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1100 Haxton Drive Suite 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fort ^.ollins CO 80525 Pnone:970-223-1804 INSURED H & H Data Services Joe Hehn 1310 Webster Avenue Fort Collins CO 80524 COVERAGES INSURERS AFF )RDiNG COVERAGE NAIC # INSURE'. A: Secure. Insurance Companies INSUF"R B: INSURER U. INSURER D: INSURER E: 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. INSK LTR NSRd TYPE OF INSURANCE UIJU POLICY NUMBER DATEPOLIYMM D CT E POLICY MMDD/YY EXPIRATION LIMITS A X GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X� OCCUR TC3140442 07/01/09 07/01/10 EACH OCCURRENCE $ 1,000,000 PREMISES (Ea occurence) $ 100 r 000 VIED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 X EPL: $100 , 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY n PRO- JECT LOC PRODUCTS - COMP/OP AGG s2,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NONOWNEDAUTOS 3140443 07/01/09 07/01/10 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) . $ X X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per acadent) -- $ GARAGE LIABILITY ANY AUTO _ - `' _ - AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ A EXCESS/UMBRELLA LIABILITY X I OCCUR CLAIMS MADE DEDUCTIBLE X RETENTION $ 10000 CU3140444 07/01/09 07/01/10 EACH OCCURRENCE $ 4000000 AGGREGATE $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED If yes, describe under SPECIAL PROVISIONS below TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EP. EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS City of Fort Collins is named as additional insured with regards CERTIFICATE HOLDER CANCELLATION FORTC-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCmLLED BEFORE THE EXPIRATION DATE THEREOF, 1 HE ISSUING INSI'RER WILL `=NDEAVOR TO MAIL 1 O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL City of Fort Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR P.O. Box 580 Fort Collins CO 80522-0580 REPRESENTATIVES. AUTH QA+EE" E P RESE NTATI VE ACORD 25 (2001/08) © 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 sucil 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. ACORD 25 (2001/08) BUSINESSOWNERS BP 04 51 01 06 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS - WITH ADDITIONAL INSURED REQUIREMENT IN CONSTRUCTION CONTRACT This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM The following is added to Paragraph C. Who Is An Insured in Section II — Liability: 3. Any person(s) or organization(s) for whom you are performing operations is also an additional insured, if you and such person(s) or organiza- tion(s) have agreed in writing in a contract or agreement that such person(s) or organiza- tion(s) be included as an additional insured on your policy. Such person(s) or organization(s) is an additional insured only with respect to li- ability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. A person's or organization's status as an in- sured under this endorsement ends when your operations for that insured are completed or the contractor's agreement is terminated. BP 04 51 01 06 © ISO Properties, Inc., 2004 Page 1 of 1 ❑