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Home My WebLink AboutOFFICESCAPES - INSURANCE CERTIFICATEaeoR> 9.CERTIFICATE OF LIABILITY INSURANCE lli'l -`_ MM�DD/YYYY) DATE" 10/1/2010 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 UUNIACI NAME: ACC011nt ASSOCiate PHONE FAX A/c No Ext: 303 -837-8500 A/C No: - - E-MAIL ADDRESS: certificate@vqic.com ' .' PRODUCER CUSTOMER ID#: JUPI INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Hartford Fire Insurance CO 0 Jupiter I, L.L.C. DBA: OfficeScapes 9900 E 51st Avenue INSURERB:St Paul Travelers INSURERC:Twin City Fire Insurance Cc Denver, CO 80238 INSURER D: INSURER E : INSURER F r1r%11=I r-Gt: CFRTIFIrATF Kill IMRPR•i nna-zanooi RFVISION 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 INSR WVD POLICY NUMBER 'POLICY EFF MM/DD/YYYY POLICY EXP MM/DD'YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR Y Y 59UENOC2298 10/1/2010 3/1/2011 EACH OCCURRENCE $1, 000, 000 _ DAMAGE TO RENTED PREMISES Ea occurrence $ 300, 000 MED EXP (Any one person) $10, 000 PERSONAL& ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: P 17 POLICY RO LOC PRODUCTS - COMP/OP AGG $2 , 000, 000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS Y . Y 59UENOC2299 - 10/1/2010 3/1/2011 COMBINED SINGLE LIMIT (Ea accident) $1, 000, 000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ g X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE Y Y �QK08300790 - 10/1/2010 3/1/2012 EACH OCCURRENCE _$5,000,000- AGGREGATE $5,000,000 DEDUCTIBLE RETENTION $10, 000 Follows Form $ X $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITYY/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A Y 59 WROC2297 - I 10/1/2010 3/1/2011 X WC STATU- OTH- IMIT ER TORY LIMITS E.L. EACH ACCIDENT $1, 000,000 E.L. DISEASE - EA EMPLOYEE $1, 000,000 E.L. DISEASE -POLICY LIMIT 1 $1, 000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) If required by written contract or written agreement, the following provisions apply subject to the policy terms, conditions, limitations and exclusions: The Certificate Holder is included as Additional Insureds for ongoing and completed operations under General Liability, Automobile Liability, and Umbrella See Attached... GtK 1 IFIGA I t HULUtK UANULLL.A I IUN The City of Fort Collins, a Municipal Corporation Attn: Director of Purchasing & Risk Management;PO Fort Collins CO 80522 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 @ 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 26 (2009/09) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: JUPI . LOC #: ACa L _. ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Van Gilder Insurance Corp. NAMED INSURED Jupiter I, L.L.C. DBA: OfficeScapes 9900 E 51st Avenue Denver, CO 80238 POLICY NUMBER CARRIER TAIT!7] EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE' OF LIABILITY INSURANCE Liability. This insurance will apply on a primary, non-contributory basis. A Blanket Waiver of Subrogation applies for General Liability, Automobile Liability, Umbrella Liability and Workers, Compensation. Additional Insured: The City of Fort Collins, Colorado, a Municipal Corporation, its officers and employees ACORD 101 (2008/01) U 2UUS AGUKU GUKPUKA 11UN. An rlgnts reservea. The ACORD name and logo are registered marks of ACORD