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466669 BISHOP-BROGDEN ASSOCIATES INC - INSURANCE CERTIFICATE
Alllll '® CERTIFICATE OF LIABILITY INSURANCE Fi/5/2011'°"YY' 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 Cor p • 1515 Wynkoop, Suite 200 Denver CO 80202 CONTACT NAME: Mable Griest PHONE FAX A/C.No,Ext: O3-8 7- 5Q A _303=$31_52�5 E-MAIL ADDRESS: mgriest@vgic.com PRODUCER CUSTOMER ID#: BISBRO INSURERS) AFFORDING COVERAGE NAIC # INSURED Bishop-Brogden Associates,Inc 333 W. Hampden Ave. #1050 INSURER A: Travelers Insurance 0 INSURER B:Hartford Insurance (Service Ce 0 INSURERC:CL-St. Paul Fire & Marine Insu Englewood CO 80110 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 809752576 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. INSRLTR TYPE OF INSURANCE A INSR W VD I POLICY NUMBER MM DD/YYYY MMIDD/YYYY LIMITS A GENERAL LIABILITY Y Y 680287OL56ATCT10 7/29/2010 7/29/2011 EACH OCCURRENCE $1, 000, 000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX_1 OCCUR E RENTED PREMISES(Ea occurrence)_ $1, 000, 000 MED EXP (Any one person) $10, 000 PERSONAL 8 ADV INJURY $1, 000, 000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OPAGG $2,000,000 POLICY FX7 PRO- LOC $ A AUTOMOBILE LIABILITY Y Y BA2871L73910 7/29/2010 7/29/2011 COMBINED SINGLE LIMIT (Ea accident) $1, 000, 000 ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ X SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ $ X NON -OWNED AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEDUCTIBLE $ $ RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE Y 34WEGKE0438 12/31/2010 12/31/2011 X WC STATU- OTH- TORY LIMIT$ ER_ E.L. EACH ACCIDENT $1, 000, 000 OFFICER/MEMBER EXCLUDED? ❑ N I A E.L. DISEASE - EA EMPLOYEE $1, 000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1, 000, 000 C Professional Liability 105322581 7/29/2010 17/29/2011 Per Claim $1.000,000 Claims Made Annual Aggregate $1, 000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I 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 and Owner are included as Additional Insureds for ongoing and completed operations under General Liability; Designated Insured under See Attached... I.CK I Ir n A I r- r1VLUr-K (,AIVItLLA 1 IL)N City of Fort 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. AUTHORIZED REPRESENTATIVE rJ @ 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: BISBRO ACD LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Van Gilder Insurance Corp. NAMED INSURED Bishop-Brogden Associates,Inc 333 W. Hampden Ave. #1050 Englewood CO 80110 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE:CERTIFICATE OF LIABILITY INSURANCE Automobile Liability; and Additional Insured only with respect to liability arising out of the Named Insured's work performed on behalf of the certificate holder and owner. This insurance will apply on a primary, non-contributory basis. A Blanket Waiver of Subrogation applies for General Liability, Automobile Liability, and Workers' Compensation. Limited Contractual Liability is included. (Attachments) ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD