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458840 C & S SPECIALTY SYSTEMS INC - INSURANCE CERTIFICATE (2)
DATE(MM/DD/YYYY) ACORD,, CERTIFICATE OF LIABILITY INSURANCE 102/09/2010 PRODUCER 303.674.5501 FAX 303.674.3571 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Colorado BW Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR PO Box 3849 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Evergreen, CO 80437 INSURERS AFFORDING COVERAGE NAIC # INSURED C&S Specialty Systems, Inc INSURER A: Scottsdale Ins Co 5609 W 6th Ave., Unit B INSURERB: State Auto Insurance 25127 Lakewood, CO 80214 INSURERC: Pinnacol Assurance 41190 INSURER D: 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 LTR DD' NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YYYY POLICY EXPIRATION DATE MM/DD/YYYY LIMITS A - GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE I OCCUR CLS1580379 02/08/2010 02/08/2011 EACH OCCURRENCE $ 1,000,000 DAMA E To R NTED PREMISES Ea occurrence$ 100,000) MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1, 000 i 000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PROJECT LOC POLICY 7 PRODUCTS - COMP/OP AGG $ 1,000,000 B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BAP222069301 07/01/2009 07/01/2010 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ X X BODILY INJURY (Per accident) $ PROPERTY DAMAGE . _ (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS / UMBRELLA LIABILITY X OCCUR CLAIMS MADE X DEDUCTIBLE RETENTION $ 10,000 XBS0001878 02/08/2010 02/08/2011 EACH OCCURRENCE $ 4, 000,000 AGGREGATE $ 4,000,000 $ $ $ C- WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE--I OFFICER/MEMBEREXCLUDED7 1. (Mandatory in NH) — i SIf PEC ALScribe underPROVISIONS below 4109630 02/01/2010 02/01/2011 X WC TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Professional Liability CLS1580379 02/08/2010 02/08/2011 LIMIT: $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 ACORD 25 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 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. AUTHORIZED REPRESENTATIVE Johna Moors ©1988-2009 ACORD CORPORATION. All riahts reserved. The ACORD name and logo are registered marks of ACORD