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Home My WebLink AboutBOULDER DESIGN ALLIANCE - INSURANCE CERTIFICATE (11)AC-0-W. CERTIFICATE OF LIABILITY INSURANCE DATE 11-04-2009 PRODUCER ONIS CERTIFICATE IS ISSUED AS A MATTER OF LY AND CONFERS NO RIGHTS UPON THE CERTIFICATION E VAN GILDER INSURANCE CORP/PHS HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 341438 P: (866)467-8730 F: (877) 905-0457 1, ALTERTHE COVERAGE AFFORDED BY THE POLICI PO BOX 33015 SAN ANTONIO TX 78265 INSURERS AFFORDING COVERAGE INSURED INSURER A: Hartford Casualty Ins Co BOULDER DESIGN ALLIANCE MR. ROB iINSURER DEKI EFFER INSURER C: 3002 MELISSA LN. INSURERD: COVERAGES l'HE 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 CONTRACTOR 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. INSq IT. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE PATE IMM/pp/YVI POLICY EXPIRATION DATEIMM/DD/VY) LIMITS GENERAL LIABILITY j EACH OCCURRENCE $1 , 0 0 0, O O O A 1 COMMERCIAL GENERAL LIABILITY 1 34 SBA LJ6557 01/01/10 01/01/11 FIRE DAMAGE IAnyonePvel I $300,000 CLAIMS MADE LX] OCCUR MED EXP (Any one person) $1 0 , 0 0 0 X' General Liab (PERSONAL &ADV INJURY $1, 000, 000 GENERAL AGGREGATE 52 , 000, 000 DEN' L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG 52, 000, 000 RO- POLICY I X I JECT I LOC A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS ( 34 SBA LJ6557 i 101/01/10 COMBINED SINGLE LIMIT $1 , O O O , 000 O 01/01/11 IEe^°°'aeon BODILY INJURY $ SCHEDULED AUTOS X HIRED AUTOS X NON -OWNED AUTOS j I (Per perconl I BODILY INJURY )Per uciden0 $ 111 PROPERTY DAMAGE $ (Per accidenn GARAGE LIABILITY AUTO ONLY EA ACCIDENT ANY AUTO ACC AUTOOTHEROTHAN _. .--- AUTO ONLY: A $ -- - - - $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE DEDUCTIBLE AGGREGATE $ $ $ $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC STATU. U I TORY LIMITS in E.L. F.ACH ACCIDENT Is I E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT 1 $ —l_ OTHER - DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Those usual to the insured's operations. I City of Fort Collins Attn: Jan Elliott 256 W. Mountain Avenue Fort Collins, CO 80521 OULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE FILIATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE (10 DAYS FOR NON-PAYMENT) TO THE CERTIFICATE ILDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO LIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 'RESENTATIVES. 25-S (7/97) A('nR0 (.nPPnAATInN IRDA ACORD. EVIDENCE OF PROPERTY INSURANCE R5451 11 04TE2009_ THIS IS EVIDENCE THAT INSURANCE AS IDENTIFIED BELOW HAS BEEN ISSUED, IS IN FORCE, AND CONVEYS ALL THE RIGHTS AND PRIVILEGES AFFORDED UNDER THE POLICY. PRODUCER PHONE -- A/C Nu Etlf/.: 8 6 6) 4 6 7 -_8_ 7.3 0 COMPANY _ VAN GILDER INSURANCE CORP/PHS PO BOX 33015 Hartford Casualty Ins Co SAN ANTONIO TX 78265 CODE: 341438 CODE: AGENCY CUSTOMER ID q: INSURED LOAN NUMBER PO4CV NUMBER BOULDER DESIGN ALLIANCE ROB 34 SBA LJ6557 DEKIEFFER 3002 MELI S SA LANE - - ----- — ------ EFFECTIVEDATE EXPIRATION DATE CONTINUED UNTIL 01 01 2 010 O 1 01 2 011 TERMINATED If CHECKED 1_ - --- BOULDER CO 80301 THIS REPLACES PRIOR EVIDENCE OA TED: PROPERTY INFORMATION LOCATION/DESCRIPTION Location: 001, Building: 001 CONSULTANT - NOC 3002 MELISSA LANE BOULDER CO 80301 COVERAGE INFORMATION_ COVERAGE/PERILS/FORMS AMOUNT OFINSURANCE DEDUCTIBLE Policy Coverages: Special Form Including Theft Business Income with Extra Expense Equipment Breakdown Coverage Location Level Coverages: Business Personal Property - Replacement Cost $21,200 $500 _REMARKS (Including Special Conditions)_ CANCELLATION THE POLICY IS SUBJECT TO THE PREMIUMS, FORMS, AND RULES IN EFFECT FOR EACH POLICY PERIOD. SHOULD THE POLICY BE TERMINATED, THE COMPANY WILL GIVE THE ADDITIONAL INTEREST IDENTIFIED BELOW 30 DAYS WRITTEN NOTICE (10 DAYS FOR NON-PAYMENT), AND WILL SEND NOTIFICATION OF ANY CHANGES TO THE POLICY THAT WOULD AFFECT THAT INTEREST, IN ACCORDANCE WITH THE POLICY PROVISIONS OR AS REQUIRED BYLAW. ADDITIONAL INTEREST NAMEANDAODRESS _ MORTG11 AGEE I ADDITIONAL INSURED X LOSS PAYEE 1 (City of Fort Collins _ OAp N Attn: Jan Elliott -- --- - 256 W. Mountain Avenue AUTHORIZED REPRESENTAT/VE Fort Collins, CO 80521/�_ I ACORD 27 (3/93) 0 ACORD CORPORATION 1993