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HomeMy WebLinkAbout132158 CTL/THOMPSON INC - INSURANCE CERTIFICATE (10)A�� o CERTIFICATE OF LIABILITY INSURANCE l2009 DA E( MIDDN Y) PRODUCER Phone: 303-837-8500 Fax: 303-831-5295 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 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA:Hartford Insurance Group CTL/Thompson, Inc. Consulting Engineers INSURER B: Pinnacol Assurance 1971 W. 12th Ave. Denver CO 80204 INSURER c:Lexington Insurance Com an 80 INSURER D: INSURER E: COVFROGFS 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 ADD'L INSR -TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE M DD POLICY EXPIRATION DATE MM LIMITS A GENERAL LIABILITY 34UUNEX2070 10/1/2009 10/1/2010 EACH OCCURRENCE $ 1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAPREMISESS GE ( a RENTED Eoccurrence) $ 1 1 000, 000 CLAIMS MADE Fx_] OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000, 000 X PD Ded: 1, 000 GENERAL AGGREGATE $ 2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2 0 0 Q 000 POLICY X PRO- LOC JECT A AUTOMOBILE X LIABILITY ANY AUTO 3 4UENEX219 0 10 / 1/ 2 0 0 9 10/1/2010 COMBINED SINGLE LIMIT (Ea accident) $ 1, 0 0 0, 0 0 0 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ X X HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO- $ AUTO ONLY: AGG A EXCESS / UMBRELLA LIABILITY 3 4 XHUEX 19 8 0 10/1/2009 10/1/2010 EACH OCCURRENCE $ 3 0 0 p 0 0 0 X I OCCUR CLAIMS MADE AGGREGATE $ 3 0 0 Q 0 0 0 $ DEDUCTIBLE $ x RETENTION $10 0 0 0 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? 618052 10 1 Z / / 0 0 9 10 / 1 / 2 010 WC STim - OTH- X T RY LIMIT E.L. EACH ACCIDENT $ 5 0 0 0 0 0 E.L. DISEASE - EA EMPLOYEE $ 5 0 0 0 0 0 (Mandatory In NH) If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 5 0 0 0 0 0 C OTHER Professional Liability Pollution Liability 015448972 10/1/2009 10/1/2010 Per Claim $1,000,000 Annual Aggregate $2,000,000 Claims Made DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS If required by written contract or written agreement, the following provisions apply subject to the policy terms, onditions, limitations and exclusions: The Certificate Holder and Owner are included as Additional Insureds for ngoing and completed operations under General Liability; Designated Insured under Automobile Liability; and Additional Insured under Umbrella / Excess Liability but only with respect to liability arising out of the Named Insured's work erformed on behalf of the certificate holder and owner. This insurance will apply on a primary, non-contributory ontinued... City of Ft. Collins; Purchasing Division P.O. Box 580 Fort Collins CO 80522 UANULLLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. 10 DAYS NOTICE FOR NON-PAYMENT OF PREMIUM. AUTHORIZED REPRESENTATIVE ACORD 25 (2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 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 This Certificate of Insurance 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 (2009101) basis. A Blanket Waiver of Subrogation applies for General Liability, Automobile Liability, Umbrella/Excess Liability and Workers' Compensation. Limited Contractual Liability is included. The Umbrella / Excess Liability policy provides excess coverage over the General Liability, Automobile Liability and Employers Liability. Additional Insured: City of Ft. Collins, Purchasing Division