HomeMy WebLinkAboutBOULDER DESIGN ALLIANCE - INSURANCE CERTIFICATE (10)ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE
11-04-2009
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
VAN GILDER INSURANCE CORP/PHS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
341438 P: (8 6 6) 4 6 7- 8 7 3 0 F: (8 7 7) 9 0 5- 04 5 7 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PO BOX 33015
SAN ANTONIO TX 78265 INSURERS AFFORDING COVERAGE
I INSURED
j INSURER A: Hart ford Casualty Ins Co
BOULDER DESIGN ALLIANCE MR. ROB
INSURERB:
DEKIEFFER
INSURER C:
3002 MEL I S SA LN .
INSURER D:
BOULDER CO 80301
INSURER E:
COVERAGES
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 TYPE OF INSURANCE POLICY NUMBER
LTR
POLICY EFFECTIVE POLICY EXPIRATION LIMITS
DATE (MM/DD/YY) DATE (MM/DD/YY)
GENERAL LIABILITY I
EACH OCCURRENCE $1, 000, 000
A
COMMERCIAL GENERAL LIABILITY 34 SBA LJ6 5 5 7
O 1/ O 1/ 10 O 1/ O 1/ 11 FIRE DAMAGE (Any one fire) s300,000
I CLAIMS MADE � X I OCCUR
MED EXP (Any one person) $1 0 , 000
X General Liab
j PERSONAL & ADV INJURY $1 , 000, 000
GENERAL AGGREGATE S2 , 000, 000
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG S2 , 000 , 000
POLICY X PRO LOC
JECT
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
$l, 000, 000
A ��� ANY AUTO 134 SBA LJ6 5 5 7
O 1/ O 1/ 10 0 1/ 0 1/ 11 (Ea accident)
ALL OWNED AUTOS
-
BODILY INJURY
SCHEDULED AUTOS
(Per person)
$
X HIRED AUTOS
BODILY INJURY
.
X NON -OWNED AUTOS
I
'� (Per accident)
$
PROPERTY DAMAGE
(Per
$
accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
�ANY AUTO
OTHER THAN EA ACC
$
AUTO ONLY: AGG
$
EXCESS LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERSLIABILITY
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Those usual to the Insured's Operations.
EACH OCCURRENCE IS
AGGREGATE I'S
S
TORY LIMITS ER
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $
E.L. DISEASE - POLICY LIMIT $
CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
45 DAYS WRITTEN NOTICE (10 DAYS FOR NON-PAYMENTI TO THE CERTIFICATE
City of Fort Collins 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
PO BOX 580 REPRESENTATIVES.
'Fort Collins, CO 80522
AUTHORI D RE SENTATIVE n /
--C.����
ACORD 25-S (7/97)
ACORD CORPORATION 1988