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HomeMy WebLinkAboutLBN INSURANCE AGENCY-JOHNSTOWN - INSURANCE CERTIFICATERo® CERTIFICATE OF LIABILITY INSURANCE OP ID PL rATE (MM/DDffYYY) 06/18/10 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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). PRODUCER - - - NAME: LBN Insurance Agcy-Johns town PHONE- - - .._ - No, E:t : (ac, No): -M ADDRESS: 4848 Thompson Pkwy, Ste 200 Johnstown CO 80534 -PRODUCER CUSTOMERID#:- .NEWCE-1 INSURER(S) AFFORDING COVERAGE NAIC# Phone:970-635-9400 Fax:970-635-9401 INSURED - INSURERA: Hartford Casualty Ins Co 00914 New Century Software, Inc. 2627 Redwing Road Suite 100 Fort Collins CO 85526 INSURERB: Pinnacol Assurance 41190 INSURERC: Landmark American Insurance Cc INSURERD: Argonaut Insurance 19801 - INSURER E : INSURER F : COVERAGES . CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED: NOM11THSTANDING ANY RFOLIIRFMENT, TERM CR.CONDITION OF ANY CONTRACT OR OTHER DOCU?+'TENT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE �X OCCUR X Contractual 34SBAGO5061 SURVEYING OPERATIONS 34SBMRU5199 09/29/09 02/09/10 09/29/10 02/09/11 EACH OCCURRENCE s2,000,000 PREMISES(Eao c1urrence) $ 300, 000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY s2,000,000 GENERAL AGGREGATE s4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JEPROCT LOC PRODUCTS - COMP/OP AGG $ 4 , 0 0 0 , 0 0 0 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS _ HIRED AUTOS NON -OWNED AUTOS 34UECTZ1909 08/05/09 08/05/10 CO accident) SINGLE LIMIT(Ea $ 1,000,000 ,O00,OOO X BODILY INJURY (Per person) - $ - BODILY INJURY (Per accident) $ PROPERTY DAMAGE - (Per accident) $ X X $ ri $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ - $ A - D WORKERS COMPENSATION•:a AND EMP'_OYERS' LIABILITY - r ; ANY PROPRIETOR/PARTNER/EXECUTIVE; j OFFICER/MEMBER EXCLUDED? u (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below / A 3433908 COLORADO 7 4' 16828546 (P OIKY ) �03/0i/10 03/01/10 03/O1/11 03/Gi. 11 X - TORY LIMITS —TUER E.L.EACHACCiDEN'f - $ i� ��i�, �i00 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1. 0 0 0 , 0 0 0 C Professional Liab Claims Made Form �LHR814170 06/20/10 06/20/11 Prof. $1, 000, 000. Liab. $10,000 ded DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required Computer Consulting/All Locations/All Operations Certificate Holde r er is an Additional Insured with respect to general liabilityp courage as their interest may appear with respect to work performed by the named insured. CERTIFICATE HOLDER CANCELLATION City of Fort Collins Purchasing Dept. Attn: Ed Bonnette P.O. Box 580 Ft. Collins CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE FT COLL I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD