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Home My WebLink About111694 TST INC CONSULTING ENGINEERING - INSURANCE CERTIFICATE (4)' 1 ® CERTIFICATE OF LIABILITY INSURANCE112/4/2009 DATE (MM/DD(YYYY) 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 Denver CO 80202 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURED TST, Inc. Consulting Engineers 748 Whalers Way Fort Collins CO 80525 C_nVFRAGFS INSURERS AFFORDING COVERAGE INSURERA:Hartford Insurance INSURER B:Hartford Insurance INSURERC:XL Specialty Insura INSURER D: INSURER E: NAIC # 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 DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE QATE IM.IDDNYYYI POLICY EXPIRATION DATEM D LIMITS A GENERAL LIABILITY 3 4 S BAVS 3 417 12 / 1/ 2 0 0 9 12/1/2010 EACH OCCURRENCE $ 10 0 0 0 0 0 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE i] OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 3 0 0 0 0 0 MED EXP (Any one person) $ 10000 PERSONAL & ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2 0 0 0 0 0 0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2 0 0 0 0 0 0 POLICY 7 PRO LOC A AUTOMOBILE LIABILITY ANY AUTO 3 4UECP02 0 3 3 12 / 1/ 2 0 0 9 12/1/2010 COMBINED SINGLE LIMIT (Ea accident) $ 1 0 0 0 0 0 0 X 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 $ AUTO ONLY: AGG A EXCESS / UMBRELLA LIABILITY X OCCUR CLAIMS MADE 3 4 SBAVS 3 417 12 / 1/ 2 0 0 9 12/1/2010 EACH OCCURRENCE $ S 0 0 0 0 0 0 AGGREGATE $ 5000000 $ DEDUCTIBLE $ X RETENTION $10 0 0 0 B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N ANY PRO PRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? 34WEGIQ8204 12/l/2009 12/1/2010 WC S- TATUOTH-. X E.L. EACH ACCIDENT $ 10 0 0 0 0 0 E.L. DISEASE - EA EMPLOYE $ 10 0 0 0 0 0 (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ 1 0 0 0 0 0 0 SPECIAL PROVISIONS below C OTHER Professional Liability Claims Made DPR9619746 12/1/2009 12/1/2010 Limit $1,000,000 Aggregate $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS If required by written contract or written agreement, the following provisions apply subject to the policy terms, conditions, limitations and exclusions: The Certificate Holder and Owner are included as Additional Insureds for ongoing and completed operations under General Liability and Designated Insured under Automobile Liability but only with respect to liability arising out of the Named Insured's work performed on behalf of the certificate holder and caner. This insurance will apply on a primary, non-contributory basis. A Blanket Waiver of Subrogation applies for ontinued... V GI�III�I<,MIG fIVLV GIB City of Fort Collins; Attn: James B. O'Neill 11 281 N. College Avenue Fort Collins CO 80524 %,AIVI,CLLA I IUIN 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 _ _ i — _ — M+IWFXu ca kLVVU1V 11 v 1a1u5-ZUUa ACUKU UUKPUKATIUN. 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. General Liability, Automobile 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.