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Home My WebLink About457580 J F SATO AND ASSOCIATES - INSURANCE CERTIFICATE (5)CERTIFICATE OF LIABILITY INSURANCE jD6E2010�) 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 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Denver CO 80202 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA:XL Specialty Insurance Co. 0 J. F. Sato & Associates, Inc. INSURER B:Hartf ord Insurance Groulp 0 5898 So. Rapp Street Littleton CO 80120 INSURERC: INSURER D: INSURER E: CnVFRAGFS 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 LTR ADDI INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE A MIDD POLICY EXPIRATION DATE M DD LIMITS $ GENERAL LIABILITY 34SBWEI8495 12/24/2009 12/24/2010 EACH OCCURRENCE $ 1 000,000 - X COMMERCIAL GENERAL LIABILITY DAMAGE RENTED PREMISESS ( Ea occurrence) $ 3 0 0 000 MED EXP (Any one person) $ 10, 000 CLAIMS MADE Fx_1 OCCUR PERSONAL & ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2 0 0 0 0 0 0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2 0 0 0 0 00 O- LOC POLICY X PRCT $ AUTOMOBILE LIABILITY ANY AUTO 34SBWEI8495 12/24/2009 12/24/2010 COMBINED SINGLE LIMIT (Ea accident) $ 1, 0 0 0, 000 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 $ EXCESS/UMBRELLA LIABILITY X OCCUR CLAIMS MADE 34SBWEI8495 12/24/2009 12/24/2010 EACH OCCURRENCE $4 000 000 AGGREGATE $ 4 0 0 0 0 0 0 $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? T EEL E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ SPECIAL PROVISIONS below A OTHER Professional Liability Claims Made DPR9615936 7/18/2009 7/18/2010 Per Claim $1,000,000 Annual Aggregate $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS If 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 and Additional Insureds under Automobile Liability; and Additional Insured under Umbrella / Excess Liability but only with respect to liability arising out of the Named Insured's work performed on behalf of the certificate holder and owner. This insurance will apply on a primary, See Attached... VCRI lr m m 1 r- f7VLUCR City of Fort Collins, Purchasing P0, Box 580 Fort Collins CO 80522 l.A1V11.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 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 AUUKU 25 (2UU9/U1) 91988-2009 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. A"Umu Za tLuuylu i) DESCRIPTIONS Continued. non-contributory basis. A Blanket Waiver of Subrogation applies for General Liability and Automobile Liability. Limited Contractual Liability is included. The Umbrella / Excess Liability policy provides excess coverage over the General Liability and Automobile Liability. (Attachments) Additional Insured: City of Fort Collins