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HomeMy WebLinkAbout125353 SAFE SYSTEMS INC - INSURANCE CERTIFICATE (7)ACC o® CERTIFICATE OF LIABILITY INSURANCE 12/20/2010 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 notconfer rights to the certificate:holder-inlieu of such en_dorsement(s). PRODUCER ` "'" .." Tagg'ar.t..'&_.Associates.,_.Inc.' I 16 0 0 .'Canyon- Boulevard .__. P.'O. Box 147 Boulder' CO 80306 NAMEACT Courtney Ouellette CISR, CLCS PHONE• ..-f._.;, :. �.� .t •FAX'�;r ;' A/C No Ext: (303)'442-1484 `"` A/C No:'(303)442-8822 ADDRESS: courtneyo@taggart nsurarice:com PRODUCER 00009054 TM INSURERS AFFORDING COVERAGE NAIC# INSURED Safe Systems, Inc. 421 S. Pierce Avenue Louisville CO 80027 INSURERA:Pi=acol Assurance 41190 INSURER B : INSURERC: INSURERD: INSURER E INSURERF: COVERAGES CERTIFICATE NUMBER:CL10111607566 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 ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS ' i_ GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR ." ,.. __ ' �' :. ., .. _ : ' '. _ _ - _ _ •� r..i ..'-_ ''_ ^''" EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ .. _. ..� ......q GENERALliGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRO- P.OLICY.. .:. 171 PRODUCTS -COMP/OP AGG 1" •• `AUTOMOB.ILELIABICITY� . -.. '"-' '' ` ANY AUTO: . ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 'i­ '.. . . - , COMBINED SINGLE LIMIT :(EP accident) $ BODILY INJURY (Per person) $ ' BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB CLAIMS -MADE EACH OCCURRENCE $ HOCCUR AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ A 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 _ 1747952 /1/2010 4/1/2011 X WC STATU- OTH- TORY E _LIMITS E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) 1M111il1111]491A:4 City of Fort Collins 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 C Ouellette CISR, CLC `J- b ACORD 25 (2009/09) © 1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200909) The ACORD name and logo are registered marks of ACORD