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Home My WebLink About125353 SAFE SYSTEMS INC - INSURANCE CERTIFICATE (9)CERTIFICATE OF LIABILITY INSURANCE 4/7/2pllvrY) 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' uY': 1,; ,;.gip_- CONTACT-Courtne Ouellette'-CISR',-"CLCS )L 11 NAME: Y Tagga_ rt & Associates, II1C :' A/C NE. Eat' (303) 442-1484 n/c No): (303)442-e822 `- E-MAIL O@ta HItinaIIlallCe. COIII ADDRESS: C011rtne y gg ` ----- -- 1600 Canyon Boulevard' - - - _ PRODUCER .00009054 .. P. O. Hox 147 ... - INSURERS AFFORDING COVERAGE NAICIf Boulder CO 80306 INSURED INSURER A:Plnnacol Assurance 41190 INSURER B : INSURERC: Safe Systems, Inc. INSURER D: 421 S. Pierce Avenue INSURER E : INSURER F: Louisville CO 80027 COVERAGES CERTIFICATE NUMBER:CL1132408510 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 TYPE OF INSURANCE ADDSUER POLICY NUMBER MMIDDIYYYY MM POLICY EFF POLICY EXP LTR SRLIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR _ :;',. .. _ .. - - - - EACH OCCURRENCE $ DAMA TO RENTED PREMISES En occurrence $ MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ •GEN'LAGGREGATE ..� ' POLICY LIMITAPPLIES PER '; 'PRO- .. ' . LOC - PRODUCTS_COMP/OP AGG $ . I c $ .`.� AUTOMOBILE LIABILITY .. .. ANY AUTO .,.., ;. ALL OWNED AUTOS .. SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ..' ... .: .. '- - --- .- COMBINED SING LE LIMB (Ea accident)' -' - BODILY INJURY (Per person) S BODILY INJURY (Per acciden0 $ PROPERTY DAMAGE (Per accident) $ $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ A WORMERS COMPENSATION ANDEMPLOYERS'LIABILITY Y/NLIM ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandate, in NH) If yes, descries under DESCRIPTION OF OPERATIONS bel. NIA 1747952 /1/2011 /1/2012 X WC STATU- OTH- E.L. EACH ACCIDENT $ 100,000 E. L. DISEASE - EA EMPLOYEE $ 100,000 EL.DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, B more space Is required) 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 Ouellette CISR, CLC `-PuA�'`J- bum ACORD 25 (2009109) (D 1988.2009 ACORD CORPORATION. All rights reserved. INS025 (20Y)M) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE 4/7/2pllvrY) 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' uY': 1,; ,;.gip_- CONTACT-Courtne Ouellette'-CISR',-"CLCS )L 11 NAME: Y Tagga_ rt & Associates, II1C :' A/C NE. Eat' (303) 442-1484 n/c No): (303)442-e822 `- E-MAIL O@ta HItinaIIlallCe. COIII ADDRESS: C011rtne y gg ` ----- -- 1600 Canyon Boulevard' - - - _ PRODUCER .00009054 .. P. O. Hox 147 ... - INSURERS AFFORDING COVERAGE NAICIf Boulder CO 80306 INSURED INSURER A:Plnnacol Assurance 41190 INSURER B : INSURERC: Safe Systems, Inc. INSURER D: 421 S. Pierce Avenue INSURER E : INSURER F: Louisville CO 80027 COVERAGES CERTIFICATE NUMBER:CL1132408510 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 TYPE OF INSURANCE ADDSUER POLICY NUMBER MMIDDIYYYY MM POLICY EFF POLICY EXP LTR SRLIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR _ :;',. .. _ .. - - - - EACH OCCURRENCE $ DAMA TO RENTED PREMISES En occurrence $ MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ •GEN'LAGGREGATE ..� ' POLICY LIMITAPPLIES PER '; 'PRO- .. ' . LOC - PRODUCTS_COMP/OP AGG $ . I c $ .`.� AUTOMOBILE LIABILITY .. .. ANY AUTO .,.., ;. ALL OWNED AUTOS .. SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ..' ... .: .. '- - --- .- COMBINED SING LE LIMB (Ea accident)' -' - BODILY INJURY (Per person) S BODILY INJURY (Per acciden0 $ PROPERTY DAMAGE (Per accident) $ $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ A WORMERS COMPENSATION ANDEMPLOYERS'LIABILITY Y/NLIM ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandate, in NH) If yes, descries under DESCRIPTION OF OPERATIONS bel. NIA 1747952 /1/2011 /1/2012 X WC STATU- OTH- E.L. EACH ACCIDENT $ 100,000 E. L. DISEASE - EA EMPLOYEE $ 100,000 EL.DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, B more space Is required) 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 Ouellette CISR, CLC `-PuA�'`J- bum ACORD 25 (2009109) (D 1988.2009 ACORD CORPORATION. All rights reserved. INS025 (20Y)M) The ACORD name and logo are registered marks of ACORD