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Home My WebLink About457580 J F SATO AND ASSOCIATES - INSURANCE CERTIFICATE (3)A4CCOR o CERTIFICATE OF LIABILITY INSURANCE 7D1E(ZOlO ) 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 Denver CO 80202 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE I NAIC # INSURED INSURER A:Hartford Insurance Groulp 0 J. F. Sato & Associates, Inc. INSURERB:XL Specialty Insurance Co. 0 5898 So. Rapp Street Littleton CO 80120 INSURERC: INSURER D: 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 ADDT 9 -TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE M POLICY EXPIRATION DATE LIMITS A GENERAL LIABILITY 34SBWN09598 12/24/2009 12/24/2010 EACH OCCURRENCE $ j 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE To RENTED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 10,000 CLAIMS MADE Z OCCUR PERSONAL & ADV INJURY $ j 000, 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 0 0 POLICY FX7 PRO-JECT F7 LOC A AUTOMOBILE LIABILITY ANY AUTO 34SBWN09598 12/24/2009 12/24/2010 COMBINED SINGLE LIMIT (Ea accident) $ 1, 0 0 0, 0 0 0 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ X 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 A EXCESS/UMBRELLA LIABILITY 34SBWN09598 12/24/2009 12/24/2010 EACH OCCURRENCE $4 000 000 AGGREGATE $ 4 0 0 O 0 0 0 OCCUR CLAIMS MADE $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? T DRY LIMIT R E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ B OTHER Professional Liability Claims Made DPR9683337 7/18/2010 7/18/2011 Per Claim $1,000,000 Annual Aggregate $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS If required by written contract or written agreement, the following provisions apply subject to the policy terms, conditions, limitations and exclusions: The Certificate Holder and Owner are included as Additional Insureds for ongoing and completed operations under General Liability, 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, non-contributory basis. A Blanket Waiver of See Attached... UtK I IFIGA I t MULUtK CANCELLATION City of Fort Collins, Purchasing PO Box 580 Fort Collins CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 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 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 A AwRu ca tcuua/u-1I U 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD fI►',I;Z0]:iEMT" 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. M"Vf[N zu k'Cuu u 1 Subrogation applies for General Liability, Automobile Liability and Umbrella/Excess Liability/ Limited Contractual Liability is included. The Umbrella / Excess Liability policy provides excess coverage over the General Liability and Automobile Liability. Additional Insured: City of Fort Collins