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HomeMy WebLinkAbout103885 COMPUTER SITES INC - INSURANCE CERTIFICATEClient#: 52180 8COMPSIT ACORDTM CERTIFICATE OF LIABILITY INSURANCE B/aznoll D8102/2011 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 endorsement(s). PRODUCER Willis of Colorado, Inc. 720 South Colorado Boulevard Suite60ON Denver, CO 80246 CONTACT NAME: PHONE 303 722-7776 303-722-8862 AIC No Exl: A/C No: E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIL# INSURER A: Valley Forge Insurance Company 20508 INSURED Computer Sites, Inc. 1225 South Huron Denver, CO 80223 INSURER B: National Union Fire Insurance o 19445 INSURER CPinnacol Assurance 41190 INSURER D: Travelers Insurance 39357 INSURER E INSURER F : COVERAGES I 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 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. I�TR TYPE OF INSURANCE NSRLSUBF MD POLICY NUMBER MMIDDpVEFF POLICY E%P (MMIDD YVYY) LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY 1-1 CLAIMS -MADE 51OCCUR XIG17957G0101 4024840653 8/01/2011 08/0112012 EACH OCCURRENCE $1,000,000 PREMISESEEooau ence $1 500000 MED EXP (My one person) $SOOO PERSONAL SADVINJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X EO X I LOC PRODUCTS - COMP/OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIREDAUTOS X NON -OWNED AUTOS Dams ACV less ded 4024840636 8/01/2011 08/01/201 COMBINED SINGLE LIMIT Ea.. Inert $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per acatlent $ XPhysical $ B UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE BE065218871 8/01/2011 08/01/2012 EACH OCCURRENCE $10000000 AGGREGATE $1 O 00O 000 CEO FXIRETENTION $1 O 000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN OFFICEWMEMBER EXCLUDED? � (Mandatory in NH) If yes, descnbs under DESCRIPTION OF OPERATIONS below NIA 4107093 8/01/2011 08/01/201 X WC STATU- OTH- E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 D Lease / Rented Equipment QT6604756R580 8/01/2011 08/0112012 $350,000 less Ded DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if mom space Is required) RE: 7081 Bridge Replacement - Whitcomb and Magnolia City of For Collins, Colorado SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O. Box 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S846914/M846091 .8TBEC_..