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Home My WebLink About457580 J F SATO & ASSOCIATES INC - INSURANCE CERTIFICATEACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MWOD WYY) 7 14 2011 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 CONTACT NAME: Kathy Van Gilder Insurance Corp. 1515 Wynkoop, Suite 200 PHONE FAX I - - AIC No : - - E-MAIL Denver CO 80202 ADDRESS: INSURER(S) AFFORDING COVERAGE NAICR INSURER A INSURED INSURERB:XL SpecialtyInsura ce Cc 37885 INSURER C: J. F. Sato & Associates, Inc. INSURER D: 5878 S. Rapp Street Littleton CO 80120 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1327671039 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 ADD INSR SD MID POLICY NUMBER POLICYEFF MNVDO POLICYEXP Mill LIMITS A GENERAL LIABILITY Y Y 34SEWNG9598 2/24/2010 2/24/2011 EACH OCCURRENCE $1, 000,000 % COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR DAMAGE T RENTED PREMISES flEa ocourrencel $300,000 MED EXP (Any one Parson) $10, 000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $2,000,000 POLICY X PRO- LOG $ A AUTOMOBILE LIABILITY Y 34SSWN09590 12/24/2010 2/24/2011 Ea accident)1, 000, 000 BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accitlent) $ % PROPERTY DAMAGE Per accitlent $ NON -OWNED HIRED AUTOS % AUTOS 8 A % UMBRELLA LIAR X OCCUR Y Y 34SEWN0959B 2/24/2010 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 EXCESS LIAB CLAIMS -MADE �2/24/2011 DED I % I RETENTION$ 10, 000 $ L WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTNE❑ OFFICER/MEMBER EXCLUDED] NIA E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE — $ (MandatoryinNH) If yes, describe under DESCRIPTION OF OPERATIONS out. E.L. DISEASE - POLICY LIMIT S B Professional Liability DPR9691181 7/18/2011 /18/2012 Per Claim $1, 000,000 Claima made Annual Aggregate $2,000,000 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, Automobile Liability and Additional Insured under Umbrella / Excess Liability but 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, See Attached... 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 reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC #: ,4 CW?" ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Van Gilder Insurance Corp. NAMED INSURED J. F. Sato & Associates, Inc. 5878 S. Rapp Street Littleton CO 80120 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 tomobile Liability and Umbrella/Excess Liability/ Limited Contractual Liability is included. The brella / Excess Liability policy provides excess coverage over the General Liability and Automobile ability. ditional Insured: City of Fort Collins ACORD 101 (2008/01) 2008 ACORD CORPORATION_ All rights reserved The ACORD name and logo are registered marks of ACORD