HomeMy WebLinkAbout113275 ALLER-LINGLE-MASSEY ARCHITECTS PC - INSURANCE CERTIFICATE (5)OP ID: JA
CERTIFICATE OF LIABILITY INSURANCE
DAT02/14DYYYY)
F oznan 1
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 endorsements .
PRODUCER 970-223-1804
Range Insurance Group
1100 Haxton Drive Suite 100
Fort Collins, CO 80525
David A. Wooldridge LUTCFAAI
CONTACT
NAMEFront
PHONE FAX
A/c No Ert: INC, No:
EMAIL
ADDRESS:
PRODUCER ALLER-1
CUSTOMER ID Y:
INSURERS AFFORDING COVERAGE
NAIL 0
INSURED Aller-Lingle-Massey
INSURER A:Pinnacol Assurance
41190
Architects P.C. -
INSURER B: The Hartford
712 Whalers Way, Suite B-100
Ft. Collins, CO 80525
INSURERC: Beazley Insurance Company, Inc
INSURER 0:
INSURER E :
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.
INSR
LTR
TYPE OF INSURANCE
ADDL
UB
POLICY NUMBER
POLICY EFF
MMIDDIYYYY
POLICY EXP
MMIDD/YYYY
LIMITS
B
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE I OCCUR
X
34SBA KJ7716 DX
04109110
04/09/11
EACH OCCURRENCE
$ 1,000,00
PREMISES Ea occurrence
$ 300,000
MED EXP (Any one person)
$ 10,00
PERSONAL S ADV INJURY
$ 1,000,00
X
EPLI $5,000
GENERAL AGGREGATE
$ 2,000,00
GEN'L AGGREGATE LIMIJECTT APPLIES PER
RO LOC
17 POLICY X PRO_
PRODUCTS AGO
$ 2,000,000
$
B
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
34UECIQ8390
04109110
04/09/11
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,00
X
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
$
$
8
UMBRELLA LAB
EXCESS LAB
X
OCCUR
CLAIMS -MADE
34SBA KJ7716 DX
04109110
04109/11
EACH OCCURRENCE
$ 1,000,00
AGGREGATE
$
DEDUCTIBLE
RETENTION $ 110,000
$
X
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE YIN
OFFICER/MEMBER EXCLUDED'
(Mandatory in NH)
It yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
1951272
04I01I70
04/01111
WC STATU- X OTH-
M
EL.EACH ACCIDENT
$ 500,00
E.L. DISEASE - EA EMPLOYEE
$ 500,00
E.L. DISEASE -POLICY LIMIT
1 $ 500,00
C
Prof. Liability
V15Q3U100201
12/14/10
12/14111
Each Occu 2,000,00
Aggregate 2,000,00
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required)
The City of Fort Collins is named additional insured with regards to general
liability.
CITY OF
City of Fort Collins
Purchasing Division
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
i FFI:bLLI+LCKUN -.?A it NP fie\ I Rf 7 I
ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD