HomeMy WebLinkAboutHUDSPETH AND ASSOCIATES, INC. - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE OP ID GD
HUDSP-1
DATE(MM/DD/YYYY)
12/16/09
PRODUCER
ForsbergHOLDER.
3575 S. ShermanhermanSt. an Company
Englewood CO 80113
Phone :.303-762-1717
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D L� i u I
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DEC 3 0 2009
L-
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
la ALTER THE COVERAGE THE E POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
�y
Hudspeth &= Associatesl[.Inc------------------
Attn • Robert Levitt
4775 S Santa Fe Circle
Englewood CO 80110
"
INSURER A: American Intl Specialty Lines
_INsuRER6 Pinnacol Assurance
"
INSURER C: Employers Mutual Casualty Cc
INSURERD:
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.
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
DETEYMM/DD/YY E
ON
PDATEY(MM/DD/YY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1000000
A
X
X COMMERCIAL GENERAL LIABILITY
PROP3778989
12/17/09
12/17/10
PREMISES(Eaoccurence)
$ 300000
CLAIMS MADE Fx_1 OCCUR
MED EXP (Any one person)
$ 25000
X Pollution Liab
PROP3778989
12/17/09
12/17/10
PERSONAL & ADV INJURY
$ 1000000
X
XCU Included
GENERAL AGGREGATE
$ 1000000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OPAGG
$ 1000000
POLICY X PRO LOC
JECT
Prof Liab
1000000
C
AUTOMOBILE
LIABILITY
ANY AUTO
2EB548611
02/04/10
02/04/11
COMBINED SINGLE LIMIT
(Ea accident)
$ lOOOOOO
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
C
C
HIRED AUTOS
NON -OWNED AUTOS
2EB548611
2E8548611
02/04/10
02/04/10
02/04/11
02/04/11
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
$ 9000000
A
X I OCCUR -71 CLAIMSMADE
PROU9964023
12/17/09
12/17/10
AGGREGATE
$ 9000000
$
DEDUCTIBLE
$
X RETENTION $ 10000
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
-
4064674
OWNERS EXCLUDED
- -
01/01/10
01/01/11
X TOX ER
RY LIMITS
E.L. EACH ACCIDENT
$ 1000000
E.L. DISEASE - EA EMPLOYEE
$ 1000000
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$ 1000000
OTHER
C
BPP
2A8548611
02/04/10
02/04/11
Limit $81600
C
Lease/Rented Equip
2CB548611 DEDUCTIBLE $soo
02/04/10
02/04/11
Limit $345000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
City of Fort Collins is named as an additional insured with respect to
general liability coverage.
CERTIFICATE HOLDER CANCELLATION
CITFORT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO
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
215 N Mason Stt IInd Floor
City Of Fort s IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
nd
PO BOX 580 REPRESENTATIVES.
Fort Collins CO 80522-0580 AUTHORIfED REP ESENTATIVE
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