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Home My WebLink AboutWILLIS OF COLORADO INC - INSURANCE CERTIFICATEACORDTM CERTIFICATE OF LIABILITY INSURANCE /29/2M/DD/YYYY) 7/29/2010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Willis of Colorado, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 720 South Colorado Boulevard HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 60ON Denver, CO 80246 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Valley Forge Insurance Company 20508 Computer Sites, Inc. INSURER B: National Union Fire Insurance o 19445 1225 South Huron INSURER C: Pinnacol Assurance 41190 Denver, CO 80223 INSURER D: Travelers Insurance 39357 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 ADD'L INSRE TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS A X GENERAL LIABILITY 4024840653 08/01/10 08/01/11 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 51OCCUR DAMAGE TO RENTED afF s1,500,000 MED EXP (Any one person) $10 000 PERSONAL & ADV INJURY $1,000,000 G17957G 0101 GENERAL AGGREGATE $2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 POLICY X PRO- JECT X LOC . A AUTOMOBILE LIABILITY ANY AUTO 4024840636 08/01/10 08/01/11 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS X n PROPERTY DAMAGE (Per accident) $ Physical Damage ACV less Ded GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG B EXCESS/UMBRELLA LIABILITY X1 OCCUR 1-1 CLAIMS MADE BE63747712 08/01/10 08/01/11 EACH OCCURRENCE $10000000 AGGREGATE $1 O 00O 000 $ DEDUCTIBLE Fx $ RETENTION $ 10 000 C WORKERS COMPENSATION AND 4107093 08/01 /10 08/01/11 X WC STA IT - OTH- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE- POLICY LIMIT $1,000,000 D OTHER Leased Wor QT6604756R860 08/01/10 08/01/11 $350,000 less Ded Rented Equipment DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS RE: 7081 Bridge Replacement - Whitcomb and Magnolia This Certificate of Insurance represents coverage currently in effect and may or may not be in compliance with any written contract. (See Attached Descriptions) City of For Collins, Colorado P.O. 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 *'fin 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 AUTHORIZED REPRESENTATIVE 4 ACORD 25 (2001/08) 1 of 3 #S699694/M699556 8TBEC 0 ACORD CORPORATION 1988 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 The Certificate of Insurance on the reverse side of this form 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. AGORD 25-S (2001/08) 2 of 3 #S699694/M699556 " The following cancellation conditions always apply: - 10 days for non-payment of premium - If policy shown, 10 days for Workers' Compensation for fraud; material misrepresentation; non-payment of premium; other reasons approved by the Commissioner of Insurance AMS 25.3 (2001/08) 3 of 3 #S699694/M699556