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HomeMy WebLinkAbout330179 INTERWEST CONSULTING GROUP - INSURANCE CERTIFICATE (6)CERTIFICATE OF LIABILITY INSURANCE DATE CERTIFICATE.� 11/12/2009 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 nkoop, Suite 200 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1515 Wy Denver nk 80202 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA:XL Specialty Insurance Co. Interwest Consulting Group INSURERB:Travelers Insurance Med A&E 1076 Lincoln Place Boulder CO 80302 INSURERC: INSURER D: Cr]VFR6GFS 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 AMT = TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS _LM B GENERAL LIABILITY 6807444M622 11/14/2009 11/14/2010 EACHOCCURRENCE $,2 00Q 000 DAMAGE To Arz= PREMISES Ea occurrence $ 1 000 000 B X COMMERCIAL GENERAL LIABILITY 6807460M671 11/14/2009 11/14/2010 CLAIMS MADE FXI OCCUR MED EXP (Any oneperson) $ 1 O O O O PERSONAL & ADV INJURY $ 2 0 0 0 Q 00 GENERAL AGGREGATE $ Q 000 000 GENt AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ Q O O O O O 0 RO LOC POLICY LZI PIFCT B AUTOMOBILE X LIABILITY ANY AUTO BA7466M429 11/14/2009 11/14/2010 COMBINED SINGLE LIMfT (Ea accident) $ 1, 0 0 0, 0 0 0 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Peracddard) $ X X HIRED AUTOS NON-OWNEDAUTOS PROPERTY DAMAGE (Per acdderv) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG B EXCESS I UMBRELLA LIABILITY CUP1330T362 11/14/2009 11/14/2010 EACH OCCURRENCE $ 1 00Q 000 X OCCUR F-ICLAIMS MADE AGGREGATE $ 1 O O O 0 0 0 $ DEDUCTIBLE - $ X RETENTION $10 0 0 0 B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUnVE� OFRCER/MEMBER EXCLUDED? XVMPFUB1339T93409 UB1341TO51 11/14/2009 11/14/2009 11/14/2010 11/14/2010 WC STATU- OTH- X I TORY LIMITS ER E.LEACH ACCIDENT $1 000 OQO E.L. DISEASE - EA EMPLOYEE $ 1 0 0 Q 0 O 0 (Mandatory in NH) U yes, describe urder SPECIAL PROVISIONS below E.L DISEASE - POLICY LIMIT $1-000,000 A OTHER Professional Liability DPR9619475 11/14/2009 11/14/2010 Per Claim $1,000,000 Annual Aggregate $3,000,000 Claims Made DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS f 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 Fort Collins Attn: Mark Laken P.O. Box 580 Fort Collins CO 80522 I;ANL;tLLA 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 A ACORD 25 (2009/01) 01988-2009 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 (2009/01) DESCRIPTIONS Continued. 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. RE: P1124 Civil Engineering Annual Additional Insured: City of Fort Collins COMMERICAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added to WHO IS AN INSURED (Section a): Any person or organization that you agree in a ,contract or agreement requiring insurance" to in - dude as an additional insured on this Coverage Part, but only with respect to liability for °biddy In- jury", 'property damage' or "personal injury' caused, in whole or in part, by your ads or omis- sions or the acts or omissions of those acting on your behalf: a. In the performance of your ongoing opera- tions; b. In connection with premises owned by or rented to you; or c. In connection with "your work' and included within the "products -completed operations hazard". Such person or organization does not qualify as an additional insured for 'bodily injury", 'property damage' or 'personal injury' for which that per- son or organization has assumed liability in a con- tract or agreement. INSURANCE (Section III) for this Coverage Part. B. The following is added to Paragraph a. of 4. Other Insurance In COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): However, if you specifically agree in a'contract or agreement requiring insurance" that the insurance provided to an additional insured under this Cov- erage Part must apply on a primary basis, or a primary and non-contributory basis, this insurance is primary to other insurance that Is available to such additional insured which covers such addi- tional insured as a named insured, and we will not share with the other insurance, provided that: (1) The 'bodily injury" or 'property damage' for which coverage Is sought occurs; and (2) The "personal injury' for which coverage is sought arises out of an offense committed; The insurance provided to such additional insured is limited as follows: d. This Insurance does not apply on any basis to any person or organization for which cover- C. age as an additional insured specifically Is added by another endorsement to this Cover- age Part. e. This insurance does not apply to the render- ing of or failure to render any 'professional services'. L The limits of insurance afforded to the addi- tional insured shall be the limits which you agreed in that "oontratd or agreement requir- ing insurance" to provide for that additional insured, or the limits shown in the Declara- tions for this Coverage Part, whichever are less. This endorsement does not increase the limits of insurance stated in the LIMITS OF after you have entered into that "contract or agreement requiring insurance'. But this. insur- ance still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the insured when the insured is an additional insured under any other insurance. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Agalnst Others To Us in COMMERCIAL GENERAL LIABILITY CON- DMONS (SsedOn IV): We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", -property damage' or 'personal injury" arising out of "your work" performed by you, or on your behalf, under a "contract or agreement requiring insurance" with that person or organization. We waive these rights only where you have agreed to do so as part of the 'contract or agreement requiring insur- ance" with such person or organization entered Into by you before, and in effect when, the "bodily CG D3 8109 07 ® 2W7 The Travelers Companies, Inc. Page 1 of 2 Includes the oopyV ted material of Insurance Services Office, Inc., wft Ns pemdsslon. COMMERICAL GENERAL LIABILITY injury" or "property damage' occurs, or the °per- erage Part, provided that the °bodily injury° and sonal injury' offense is committed. °property damage' occurs, and the 'personal in. D. The following definition is added to DEFINITIONS jury' is caused by an offense committed: (Sectlon V): a. After you have entered into that contract or 'Contract or agreement requiring insurance' I agreement; means that part of any contract or agreement un- b. While that part of the contract or agreement is der which you are required to include a person or in effect; and organization as an additional insured on this Cov- c. Before the end of the policy period. Page 2 of 2 0 2007 The Travelers Companies, Inc. CG 03 8109 07 Includes the copyrighted matwial of Insurance Services Office, Inc., with its permission. COMMERCIAL GENERAL LIABILITY However, this exclusion does not apply to your liability with respect to your conduct of the business of any current or past partner- ship or joint venture: a. That is not shown as a Named Insured in the Common Policy Declarations, and b. In which you are a member or partner where each and every one of your co - ventures in that joint venture is an archi- tectural, engineering, or surveying firm. 2. This Provision P. does not apply to any per- son or organization for which coverage is ex- cluded by another endorsement to this Cov- erage Part. 3. The insurance provided by this. Provision P. shall be excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, which is avallable covering your liability with respect to your conduct of the business of any current or past partnership or joint venture that is not shown as a Named Insured in the Common Policy Declarations and which is issued to such partnership or joint venture. 4. PER PROJECT GENERAL AGGREGATE LIMIT I. Paragraph 2. of LIMITS OF INSURANCE (Section 111) is deleted and replaced by the following: The General Aggregate Limit is the most we will pay for the sum of: a. Damages under Coverage B; and b. Damages from 'occurrences' under Cov- erage A and for all medical expenses caused by accidents under Coverage C which cannot be attributed only to opera- tions at a single "project'. 2. The following is added to LIMITS OF IN- SURANCE (Section Ili): A separate Per Project General Aggregate Limit applies to each 'project' for all sums which the insured becomes legally obligated to pay as damages caused by 'occurrences' under Coverage A and for all medical ex- penses caused by accidents under Coverage C which can be attributed only to operations at a single 'project', and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations for this Coverage Part. Any payments made under Coverage A for damages and under Coverage C for medical expenses shall reduce the Per Project Gen- eral Aggregate Limit for that 'project', but shall not reduce: a. Any other Per Project General Aggregate Limit for any other project'; b. The General Aggregate Limit; or c. The Products -Completed Operations Ag- gregate Limit. The limits shown in the Declarations for this Coverage Part for Each Occurrence, Dam- age To Premises Rented To You and Medical Expense are also subject to the Per Project General Aggregate Limit when the Per Pro. ject General Aggregate Limit applies. 3. As used in the Provision Q.: 'Project' means an area away from premises owned by or rented to you at which you are performing operations pursuant to a contract or agreement. For the purposes of determin- ing the applicable aggregate limit of insur- ance, each °project' that includes premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right- of-way of a railroad shall be considered a sin- gle "project'. R. KNOWLEDGE AND NOTICE OF OCCUR- RENCE OR OFFENSE The following is added to Paragraph 2. Duties In The Event of Occurrence, Offense, Claim Or Suit of COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): Notice of an °occurrence° or of an offense which may result in a claim • must be given as soon as practicable after knowledge of the "occurrence' or offense has been reported to you, one of your 'executive officers' (if you are a corporation), one of your partners who is an individual (if you are a partnership), one of your managers (if you are a limited liability company), one of your trustees who is an individual (if you are a trust), or an 'employee" (such as an insurance, loss control or risk manager or administrator) designated by you to give such notice. Knowledge by any other 'employee' of an "occur- rence" or offense does not imply that you also have such knowledge. Page 6 of 8 0 2007 The Travelers Conver"s, Inc. CG D3 79 09 07 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorse- required of you by a written contract executed ment, the provisions of the Coverage Form apply prior to any "accident" or "loss", provided that the unless modified by the endorsement. "accident" or "loss" arises out of the operations Paragraph 5. Transfer of Rights Of Recovery contemplated by such contract. The waiver ap- Against Others To Us of the CONDITIONS section plies only to the person or organization desig- is replaced by the following: Hated in suchh contract, 5. Transfer Of Rights Of Recovery Against Oth- ers To Us We waive any right of recovery we may have against any person or organization to the extent CA T3 40 08 08 © 2008 The Travelers Companies, Inc. Page 1 of 1 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorse- a written contract or agreement that is signed and ment, the provisions of the Coverage Form apply executed by you before the "bodily injury" or "property unless modified by the endorsement. damage" occurs and that is in effect during the policy The following is added to the Section II — Uability period is an "insured" for Liability Coverage, but only Coverage, Paragraph A.I. Who Is An Insured Pro- for damages to which this insurance applies and only to the extent that person or organization qualifies as vision: an "insured" under the Who Is An Insured provision Any person or organization that you are required to contained in Section II. include as additional insured on the Coverage Form in CA T4 37 08 o8 C 2008 The Travelers Companies, Inc. Page 1 of 1 TRAVELERST POLICY NUMBER: WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 00 0313 (00) _ 01 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an 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 any one not named in the Schedule. SCHEDULE DESIGNATED PERSON: DESIGNATED ORGANIZATION: ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS COMPLETED A WRITTEN AGREEMENT TO PROVIDE THIS WAIV$R. DATE OF ISSUE: ST ASSIGN: