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Home My WebLink AboutIN-SITU INC - INSURANCE CERTIFICATE (3)Client#: 49195 INSIN2 ACORD.f CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 8/31 /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 Flood & Peterson Ins., Inc. P. O. Box 578 Greeley, CO 80632 970356-0123 CONTACT NAME: Sandy Schlfferns PHONE 970-266-7107 970-506-6845 NC No Ext: A/C No: AO A '. sandy.schiffernsOfpinsurance.com CUSTOMER ID r: INSIN2 INSURER(S) AFFORDING COVERAGE NAICa INSURED In -Situ, Inc. 221 E Lincoln Ave Fort Collins, CO 80524 INSURER A: OneBeacon INSURER B: Pinnacol Assurance INSURER C: Zurich INSURER D 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 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 DDL UBR POLICY NUMBER POLICY EFF MWDDNYYY POLICY EXP MWDD/YYYY LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 51OCCUR 7110127690000 9/01/2011 09/01/2012 EACH OCCURRENCE $1000000 DAMAGE TTR� PREMISES JEa occurrence S500000 MED EXP (Any we person) $1 O 000 PERSONAL 6 ADV INJURY $1,000,000 GENERALAGGREGATE $2,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES PER: JeCT PRO LOC PRODUCTS - COMP/OP AGO $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS DOC 7110127690000 9/01/2011 09/01/2012 COMBINED SINGLE LIMIT (Ea accident) $1 OOO OOO X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ X $ A X UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE 7110127690000 9/01/2011 09/01/2012 EACH OCCURRENCE s5,000,000 AGGREGATE s5,000,000 DEDUCTIBLE RETENTION o $ X $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOPARTNER/EXECUTIVE R/ OFFICER/MEMBER EXCLUDED? F1 (Mandatory In NH) Idescribe under DESCRPTION OF OPERATIONS below N/A 4126084 9/01/2011 09101/2012 OTH- X WCSTATLIMIT E.L. EACH ACCIDENT $1000000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE- POLICY LIMIT 1 $1,000,000 C Other States WC & Employer's Liab. WC463291300 9/01/2011 r 09/01/201 $1,000,000 Each ACC; Each Em l; Policy Limit DESCRIPTION OF OPERATIONS / LOCATIONS VEHICLES (Attach ACORD 101, Additional Remarlo Schedule, H more space is required) City of Fort Collins 300 Laporte Ave Fort Collins, CO 80526 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 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD