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457580 J F SATO AND ASSOCIATES - INSURANCE CERTIFICATE (2)
ACORD. CERTIFICATE OF LIABILITY INSURANCE 07/29/09° PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION' Van Gilder Insurance Corp. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICAT 1515 W nkoo ,Suite 200 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND Orpy, Y p ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Denver, CO 80202 303 837-8500 INSURERS AFFORDING COVERAGE INSURED J. F. Sato & Associates, Inc. 5898 So. Rapp Street Littleton, CO 80120 COVERAGES INSURER A: Hartford Casualty Insurance Co INSURER B: National Union Fire Ins Co of Pitts - INSURER C: XL Specialty Insurance Co. 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. NSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MWDD/YY POLICY EXPIRATION DATE MWDD/YY LIMITS A GENERAL LIABILITY 34SBAEI8495 12/24/08 12/24/09 EACH OCCURRENCE $1,000,000 FIRE DAMAGE (Any one fire) $300 000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE Fx_1 OCCUR MED EXP (Any one person) $1 U 000 PERSONAL & ADV INJURY $1 000 000 i GENERAL AGGREGATE s2,0001000 GEN'L AGGREGATE LIMITAPPLIES PER: PRODUCTS -COMP/OP AGG $2 00O 000 PROJECT LOC POLICY 7 A AUTOMOBILE LIABILITY ANY AUTO 34SBAEI8495 12/24/08 12/24/09 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO I $ AUTO ONLY: AGG B EXCESS LIABILITY EBU015647400 12/24/08 12/24/09 EACH OCCURRENCE s4,000,000 X OCCUR CLAIMS MADE AGGREGATE s4,000,000 $ DEDUCTIBLE $ RETENTION $ COMPENSATION AND EMPLOYERS' LIABILITY WC SLIMIT OTH- TATUWORKERS R E.L. EACH ACCIDENT $ E.L. DISEASE - EAEMPLOYEE $ E.L. DISEASE - POLICY LIMIT 1 $ C OTHER Professional DPR9615936 07/18/09 07/18/10 $1,000,000 per claim Liability $2,000,000 annl aggr. Claims Made DESCRIPTION OF OPERATIONS/LOCATIONSA/EHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS *Except 10 days notice for non-payment of premium. If required by written contract or written agreement, the City of Fort Collins is included as Additional Insured for ongoing operations under General Liability and Automobile Liability. *Except 10 days notice for non-payment of premium. It City of Fort Collins, Purchasing PO box 580 Fort Collins, CO 80522 SHOULD ANYOFTH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TH E EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL30* DAYSWRITTEN NOTICETOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL IMPOSE NOOBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURERJTS AGENTS OR " REPRESENTATIVE 0 ACORD 25-S (7/97)1 of 2 #M570803 KAB © 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. ACORD 25-S (7/97) 2 of 2 #M5 7 0 8 0 3