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Home My WebLink About310036 BLUE DOT SOLUTIONS INC - INSURANCE CERTIFICATE (4)A� " CERTIFICATE OF LIABILITY INSURANCE DATE 11-04-201)0 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 COBIZ INSURANCE INC/PHS 340725 P: (866)467-8730 F: (877)905-0457 C PHONE X n'c"oExt): (866)467-8730 I(AlC,Nol: (877)905-045 PO t BOX 33015 ADDRESS: PHUOUCER CUSTOMER ID q: SAN ANTONI O TX 78265 INSURER(S) AFFORDING COVERAGE NAIC p INSURED INSURER A : Hartford Casualty TIls Co INSURER B BLUE DOT SOLUTIONS, INC 1900 GRANT ST . STE 1200 INSURER C INSURER D DENVER CO 80203 INSURER E INSURER F [di]9q:Te[N� a�:i�ly[�1/��►R1LTil:l�: E7��][:�GI►�t►TIILTif7�: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE OR 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. LTR I TYPE OF INSURANCE INSR I WVDI POLICY NUMBER (MMIDO/YYYYI I IMM/DD/YYYY) LIMITS A LGENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE II OCCUR u General Llab X 34 SBA IR0798 12/01/2010 EACH OCCURRENCE $ 1,000, 000 PREMISES (Ea occurrence) S 300,000 MED EXP (Any one person) $ 10,000 12/01/2011 1 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 2,000,000 PRODUCTS - COMP/OP AGG S 2, 000,000 I I $ j1 _GEN'L AGGREGATE LIMIT APPLIES PER: POLICY i ! PELT x I LOC A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS. HIRED AUTOS NON -OWNED AUTOS 34 SBA IR0798 12/01/2010 12/01/2011 COMBINED SINGLE LIMIT (EA accident) $1,000,000 ,000,000 I BODILY INJURY (Per person) 19 l BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per occident) $ X X $ $ A UMBRELLA LIAB X I OCCUR EXCESS LIAB I CLAIMS -MADE 34 SBA IR0798 12/01/2010 12/01/2011 EACH OCCURRENCE I $ 5,000,000 AGGREGATE $ 5,000,000 I DEDUCTIBLE �_X! RETENTION $ 10 000 $ $ 1 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER+EXECUTIVE OFFICER%MEMBER EXCLUDED? u (Mandatory in NH) I yes, describe Linder DESCRIPTION OF OPERATIONS below N / A WC STAI U- I Oi H- TOP.Y LIMITS ER L E.L. EACH ACCIDENT I $ E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE - POLICY LIMIT 1 $ A Technology Ego 34 SBA IR0798 12/01/2010 12/01/2011 11000, 000/1, 000, 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additlonal Remarks Schedule, If more apace Is required) Those usual to the Insured's Operations. CEH I IFICA I E HULOEH CANCELLATION City of Fort Collins Attn: Jim Hume 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. AUTHORIZED REPRESENTATIVE 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD ACC)R" CERTIFICATE OF LIABILITY INSURANCE 11-04D20110 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 COBIZ INSURANCE INC/PHS 340725 P: (866)467-8730 F: (877)905-0457 CONTACT PHONE FAX A/c NoExt): (866)467-8730 (A/C,No): (877)90S-045 PO BOX 33015 ADDRESS: PHUDUCEH CUSTOMER ID a: SAN ANTONI O TX 78265 INSURER(S) AFFORDING COVERAGE NAIC p INSURED INSURER A : Hartford Casualty Ins Co INSURER B BLUE DOT SOLUTIONS, INC 1900 GRANT ST . STE 1200 INSURER C INSURER D DENVER CO 80203 E -INSURER INSURER F 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 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. LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYYI IMM/DD/YYYY) LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1 0 0 0 0 0 0 PREMISES IEa occurrence) $s 3 O O O 0 0 A I CLAIMS -MADE U OCCUR X General Liab X 34 SBA IR0798 12/01/2010 MED EXP (Any one person) $ 10,000 12/01/2011 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT ALPPLILIE�S PER: r POLICY I_ PRC " LOC PRODUCTS - COMP/OP AGG $ 2,000, 000 $ . AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea eccident) $ 1,000,000 A ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS I HIRED AUTOS 34 SBA IR0798 12/01/2010 12/01/2011I BODILY INJURY (Per person) $ � X BODILY INJURY (Per accident) $ PROPERTY DAMAGE I (Per accident) $ X I NON -OWNED AUTOS I $ I I $ V1 UMBRELLA LAB X OCCUR I EACH OCCURRENCE I$ 5,000,000 AGGREGATE $ 5,000,000 A EXCESS LIAB I (CLAIMS -MADE j I DEDUCTIBLE 34 SBA IR0798 12/01/2010 12/01/2011 $ X I RETENTION $ 10,000 I$ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY v / N I ANY PROPRIETOMPA.RTNER;EXECUTIVE� 1 OFF! CEWMEMBEREXCLUDED? U (Mandatory In NH) N / A j I WC STATU• OTH- TORY LIMITS I I ER I E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEEI $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Technology E&O 34 SBA IR0798 12/01/2010 12/01/2011 1, 000, 000/1, 000, 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION City of Fort Collins Attn: Jim Hume 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. AUTHORIZED RfPRESENTATIVE 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD