The URL can be used to link to this page

Home My WebLink About280698 NORTH STAR DESIGN INC - INSURANCE CERTIFICATE (4)AC40R b' CERTIFICATE OF LIABILITY INSURANCE DATE 9/3/2(OlODrrvrY) 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 Van Gilder Insurance Corp. 1515 Wynkoop, Suite 200 Denver CO 80202 CONTACT NAME: Dawn Gaba an PHONE FAX A/C No E , U- - 8 3 7 - A/C,No: - - E-MAIL ADDRESS: d aba an@v ic. com PRODUCER CUSTOMER ID #: NORSTA7 INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURERA:XL Specialty Insurance Co. 0 North Star Design, Inc. 700 Automation Dr., Unit 1 INSURER B:Hartford Insurance (Service Ce 0 INSURERC: Windsor CO 80550 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:1644059007 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. 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE D�JLI INSR UBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRCT LOC PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS I COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ . BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ UMBRELLA LIAB EXCESS LIAB HCLAIMS-MADE OCCUR 1 EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ g WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ D? OFFICER/MEMBER EXCLUDE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 34WECT02391 9/1/2010 9/1/2011 X WC STATU- OTH- T IM ER E.L. EACH ACCIDENT $1, 000, 000 E.L. DISEASE - EA EMPLOYE $1, 000, 000 E.L. DISEASE - POLICY LIMIT 1 $1, 000,000 A Professional Liability I Claims Made �531553 9/1/2010 9/1/2011 Per Claim $500,000 Annual Aggregate $1, 000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION City of Fort Collins; Purchasing Division PO Box 580 Fort Collins CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Q n 1QRR_2D(1Q Arf)Pn Cr1RpnPATI171M All rinh4c rca.—A ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD