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Home My WebLink About428558 NUSZER KOPATZ INC - INSURANCE CERTIFICATEA� �® CERTIFICATE OF LIABILITY INSURANCE F DATE 1 10-20/-20110 THIS CERTIFICATEIS 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 SUBROGATIONIS 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 BANKS INSURANCE AGENCY, INC/PHS 342221 P: (866)467-8730 F: (877)905-0457 CONTACT PHONE (A/CNoExt): (866)467-8730 (A!C,No): (877)905-0457 ADDRESS: PO BOX 33015 SAN ANTON I O TX 78265 PRODUCER CUSTOMER ID k: INSURER(S) AFFORDING COVERAGE I NAIC k INSURED INSURER A : Hartford Casualty IIls CO INSURER B NUS ZER KOPATZ , INC. 1117 CHEROKEE ST STE 200 INSURER C INSURER D DENVER CO 80204 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS !S TO C.'_RT'EY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED AROVE 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. I��FF LTR TYPE OF INSURANCE IINSR I WVDI POLICY NUMBER (MM/DD/YYYY) POLICY UP I (MM,DD/YVYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE I 2,000,000 A COMMERCIAL GENERAL LIABILITY I CLAIMS -MADE XI OCCUR xI General Liab X 34 SBA UH6408 12/15/2010 ILI PRREEMI I1�TEa�ocFourrence) $ 300,000 MED EXP (Any one person) $ 10,000 12/15/2011IPERSONAL &ADVINJURY $ 2,000,000 I GENERAL AGGREGATE $ 4,000, 000 GENT AGGREGATE LIMIT APPLIES PER: POLICY I_I PEC LOC I PRODUCTS - COMP/OP AGG $ 4, 000, 000 $ A AUTOMOBILE �I �i LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS 34 SBA UH6408 12/15/2010 12/15/2011 COMBINED SINGLE LIMIT (Ea accident) $ 2,000, 000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X I " NON -OWNED AUTOS $ I I I I I I $ A I X 1 ~il UMBRELLA LIAR X OCCUR EXCESS LIAB CLAIMS -MADE 34 SBA UH6408 12/15/2010 12/15/2011 EACH OCCURRENCE $ 2 0 O O 000 AGGREGATE $ 2 0 O O 000 DEDUCTIBLE X! RETENTION $ 10 000 $ $ I WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETORrPARTNER,'EXECUTIVE OFFICERMEMBER EXCLUDED? u (Mandatory In NH) If yes, describe Under DESCRIPTION OF OPERATIONS below N / A I WC STATU- OTH- TORY LMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT 1 $ I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Tho$eusual to the Insured's Operations. City of Ft Collins is also an Additional Insured per the Business Liability Coverage Form SS0008. %,cmIiri%,Hlc nVLUtn UAINUtLLAIIUN City of Ft Collins Purchasing PO Box 580 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, AUTHORIZE R PRESENTATIVE ` Ix� 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD 1 ® AC40R 0 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10-20-2010 THIS CERTIFICATEIS 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 ADDITIONALINSURED, the policylies) must be endorsed. If SUBROGATIONIS 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 BANKS INSURANCE AGENCY, INC/PHS 342221 P:(866)467-8730 F:(877)905-0457 CONT CT NAME: PHONNo Ext1: (866) 467-8730 n A(A/C, No): (877) 905-0457 PO BOX 33015 ADDRESS: PHODUCEK SAN ANTONIO TX 78265 CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A : Hartford Casualty Ins CO INSURER B NUSZER KOPATZ , INC. 1117 CHEROKEE ST STE 200 INSURER C DENVER CO 80204 INSURERD: INSURER E INSURER F : I - 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 .I 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 OF INSURANCE AL)uLTYPE IINSRI WVDI POLICY NUMBER POLICY EFF I (MM/DD/YYYV) POLICY EXP I (MM/DDlYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE S 2,000,000 COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) S 300,000 I CLAIMS -MADE I X I OCCUR I MED EXP (Any one person) $ 10,000 A [XIGeneral Liab X 34 SBA UH6408 12/15/2010 12/15/2011 PERSONAL & ADV INJURY I S 2,000,000 GENERAL AGGREGATE S 4,000,000 PRODUCTS - COMP/OP AGG S 4,000,000 I GEN'L AGGREGATE LIMIT APPLIES PER: Li POLICY I PEO X I LOC $ AUTOMOBILE LIABILITY ECOMBINED t)SINGLE LIMIT $ 2, 000,000 ANY AUTO BODILY INJURY (Per person) I $ ALL OWNED AUTOS (SCHEDULED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE IPe,accidenO $ A�XI HIRED AUTOS 34 SBA UH6408 12/15/2010 12/15/2011 X NON -OWNED AUTOS $ X I UMBRELLA LIAB X I OCCUR EACH OCCURRENCE I S 2,000,000 EXCESS LIAB I CLAIMS -MADE AGGREGATE I S 2,000,000 A 34 SBA UH6408 12/15/2010 12/15/2011 L—I DEDUCTIBLE $ $ X I RETENTION $ 10,000 WORKERS COMPENSATION TH- LI ORY L MITS WC STATUOER AND EMPLOYERS' LIABILITYy / N - . ANY PROPRIETOR/PARTNER/EXECUTIVES Meiideory In NH) EXCLUDED? u N / A E.L. EACH ACCIDENT I $ E.L. DISEASE - EA EMPLOYED $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT I $ i I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Those usual to the Insured's Operations. ltlRMIIIaL•1Lll1;0:Lei 4•Ja: A_1CL9a1IL'1111C9► City of Ft Collins Purchasing PO Box 580 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. AUTHORIZEQ R PRESENTATIVE ` 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD