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HomeMy WebLinkAbout398304 LAUREL HILL GIS - INSURANCE CERTIFICATEACORD CERTIFICATE OF }LIABILITY INSURANCE F DATE (MM/DD/VYYY)06/30/2010 PRODUCER (970)679-7333 FAX (866)456-4265 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Ewing -Leavitt Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 4025 St. Cloud Dr. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 100 Loveland, CO 80538 INSURERS AFFORDING COVERAGE NAIC # INSURED LAUREL HILL GIS INC. INSURER A: Assurance Company- of -America -- 19305 307 BROSS ST INSURER B: Pi nnacol Assurance 41190 LONGMONT, CO 80501-5427 INSURERC: Philadelphia Insurance Company 023850 INSURER D: INSURER E: CAVFRAnFR 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 NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD/YYYY POLICY EXPIRATION DATE MMIDD/YYYY LIMITS GENERAL LIABILITY PPS037575108 02/01/2010 02/01/2011 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMA E ( RENTED PREMISESS Ea occurrence $ 1,000,000 CLAIMS MADE Fx] OCCUR MED EXP (Any one person) $ 10, OOO PERSONAL & ADV INJURY $ A GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PRO LOC JECT AUTOMOBILE LIABILITY ANY AUTO PPS037575108 02/01/2010 02/01/2011 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ A ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X BODILY INJURY (Per accident)- $ X `PROPERTY DAMAGE (Per accident) - -_ -- $ - GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS I UMBRELLA LIABILITY PPS037575108 02/01/2010 02/01/2011 EACH OCCURRENCE $ 1,000,000 X OCCUR F—ICLAIMS MADE AGGREGATE $ 1,000,000 A $ $ DEDUCTIBLE $ RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY OFFICEOPRIET ER/EXCLUDED? ECUTIVE.� (Mandatory in NH) 4091796 04/01/2010 04/01/2011 X TORY L M TS ER E.L. EACH ACCIDENT $ 1-,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 C OTHER Errors & Omissions PHSD454936 10/26/2010 10/26/2011 $1,000,000 per claim $7,500 deductible DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN City of Fort Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Attn • John Stephens IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR PO BOX 580 REPRESENTATIVES. Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE cam Katie McAvo /KAMCAV AUUKU ZO (-LVUy/U1) U 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACOR CERTIFICATE OF LIABILITY INSURANCE of/23/2010 PRODUCER (970)679-7333 FAX (866)456-4265 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Ewing -Leavitt Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4025 St . Cloud Dr. . HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 100 Loveland, CO 80538 INSURERS AFFORDING COVERAGE NAIC # INSURED LAUREL HILL GIS INC. - INSURER A: Assurance Company of America 19305 307 BROSS ST J INSURERB: Pinnacol Assurance 41190 LONGMONT, CO 80501-5427 MAR 2 2010 1 INSURERC: Philadelphia Insurance Company 023850 J L, _j INSURER D: I INSURER E: nnVFRAnFS 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 ADDT TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE (MM/DDIYYI LIMITS GENERAL LIABILITY PPS037575108 02/01/2010 02/01/2011 EACHOCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 1 000,000 - CLAIMS. MADE [—j-] OCCUR -- - -- - MED EXP_(Anyone person)— • •$_- - -- - 10,000 A PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PRO LOC JECT AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY PPS037575108 02/01/2010 02/01/2011 EACH OCCURRENCE $ 1,000,000 X OCCUR CLAIMS MADE AGGREGATE $ 1,000,000 A $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND 4091796 04/01/2009 04/01/2010 X I WC STATU- O R B - EMPLOYERS' LIABILITY ANY PROP RIETOR/PA.RTNER/EXECUTIVE. OFFICER/MEMBER EXCLUDED? El. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE _ $ 1 , 000, 000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 OTHER Errors & Omissions PHSD454936 10/26/2009 10 26 2010 / / $1,000,000 per claim C $7,500 deductible DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS City of Fort Collins Attn: John Stephens PO BOX 580 Fort Collins, CO 805 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE C m C, `- Katie MCAVOY/KAMCAV O ' ACORD 25 ©ACORD CORPORATION 1988