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286191TELESUPPORT SERVICES - INSURANCE CERTIFICATE
A nn PY r% CERTIFICATE OF LIABILITY INSURANCE 0511M/D7/2011o11) s/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 endorsemenl(s). PRODUCER CONTACT NAME: Centennial Insurance Agency, LLC Pa'N.E.E : 719.544.1111 ; Ne:719.545.5120 EMAIL ADDRESS: 1515 Fortino Blvd. 2nd Floor Pueblo, CO 81008 PRODUCER 00012029 CUSTOMERIDII: INSURERS) AFFORDING COVERAGE NAIC0 ly INSURED INSURER A: Colorado Casualty Insurance Co 41785 Telesupport Services, Inc.& Flexible INSURERB: Pinnacol Assurance 41190 Technology Inc. & Great Terrain INSURER C: Products Inc. INSURER D: 4830 Pearl 'St. - INSURER E: Boulder, CO 80301 1 INSURER F: COVERAGES CERTIFICATE NUMBER: 2011 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 CONTRACTOR 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 ADDLSUBR INSR WVD POLICY NUMBER POUCYEFF MMMD PODCYEXP MMMD NYM LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR CBP866758 05/23/2011 05/23/2012 EACH OCCURRENCE $ 1,000,00 DAMAGE TO R PREMISES EaEoc D nc $ 100,000 MED EXP(My one person) $ 15,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY F7 PRO LOC JECT PRODUCTS - COMP/OP AGG $ 2,000,00 $ AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS - COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A UMBRELLA LAB EXCESS LAB OCCUR CLAIMS -MADE CU8702905 05/23/2011 05/23/2012 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ 1,000,000 DEDUCTIBLE RETENTION $ 10,00 E X S B WORKERS AND EMPLOYERS'NLABIILIY YIN ON OFFICER/MEMBERIPARTNEW ECUTIVEā (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Nto 345405510/91/2916 18/01/2911 WC STATU. TORYLMIITS DTR E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE -EA EMPLOYEE S 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins Ed Bonnette, CPM AUTHORIZED REPRESENTATIVE 215 N. Mason St. 2nd Floor Fort Collins, CO 80522 Douglas Helzer/CHRIS ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD