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HomeMy WebLinkAbout376039 THE BALLARD GROUP INC - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE F DATE 1YYYYl 8/30/2011 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 endorsemenl(s). PRODUCER Van Gilder Insurance Corp. 1515 Wynkoop, Suite 200 Denver CO 80202 CONTACT NAME: PHONE FAX _LC,No ExW - - NC,No:303-831-5995 E-MAIL ADDRESS: amacias®ygic.com PRODUCER CUSTOMER ID p: BALGRO INSURER(S) AFFORDING COVERAGE NAICR INSURED 7 Did V INSURERA:Hart£ord Insurance Company 0 The Ballar Group, Inc. P.O. 36007 INSURER B: Travelers Casualty & Surety Cc 19308 INSURER C: Denver CO 80236 INSURER D INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1519162623 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 TR TYPE OF INSURANCE AODLISUBR POLICYNUMBER POLICY BEE MMIDDY EXP LIMITS A GENERAL LIABILITY Y Y 34SBWEU2032 9/1/2011 9/1/2012 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY DAMAGE To AMA ETo RENTED PREMISES Ea occurrence $ 300000 CLAIMS -MADE aOCCUR MED EXP(Any one person) $10000 PERSONAL B ADV INJURY $1000000 GENERAL AGGREGATE $2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2000000 POLICY PRO- X LOC S A AUTOMOBILE LIABILITY Y Y 34SBWEU2032 9/1/2011 9/1/2012 COMBINED SINGLE LIMIT E. aaudart) $1000000 ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ x X $ NON -OWNED AUTOS $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DEDUCTIBLE $ $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 1, / N WC STATU- OTH- TCRY LIMITS ER $ ANY PROPRIETOR/PARTNER/EXECUTIVEâť‘ OFFICER/MEMBER EXCLUDED) N/A E.L. EACH ACCIDENT EL.DISEASE - EA EMPLOYE $ (Mandatory In NH) If yes, itescdbe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT I $ H Professional Liablity 105334565 9/1/2011 9/1/2012 Per Claim $1,000, 000 Claims Made Annual Aggregate $2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule, nations 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 and Automobile Liability See Attached... City of Fort Collins P.O. Box 580 Fort Collins CO 80522-0580 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 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD ACO AGENCY CUSTOMER ID: BALGRO LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Van Gilder Insurance Corp. NAMED INSURED The Ballard Group, Inc. P.O. 36007 Denver CO 80236 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE:CERTIFICATE OF LIABILITY INSURANCE ly with respect to liability arising out of the Named Insured's work performed on behalf of the rtificate holder and owner. This insurance will apply on a primary, non-contributory basis. A Blanket iver of Subrogation applies for General Liability and Automobile Liability. Limited Contractual ability is included. ditional Insured: City of Fort Collins, CO © 2008 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD