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HomeMy WebLinkAbout132158 CTL/THOMPSON INC - INSURANCE CERTIFICATE (14)ACORO® CERTIFICATE OF LIABILITY INSURANCE II DATE(MM/DD/YYYY) I 9 22 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 NAME: PHONE FA% -IEMC.,NP.Estl - 37-8500 AIC 144303- 3-1=5295— Van Gilder Insurance Corp. 1515 Wynkoop, Suite 200 IL Denver CO 80202 ADDRESS: INSURER(S) AFFORDING COVERAGE NAICM INSURER A:PinnaCol Assurance INSURED INSURER B:LeXingtOn Zn5LlranCe COm�O�LA 19437 INSURER c-Hart ford Insurance Grouta CTL/Thompson, Inc. INSURER D: 1971 W. 12th Ave. Denver CO 80204 INSURER E NSURER F COVERAGES CERTIFICATE NUMBER: 695287936 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. ILTR TYPE OF INSURANCE INSR ISWVD POLICY NUMBER MM OIOY/YYYY MMIDDYIVYYYPJ LIMITS C GENERAL LIABILITY Y Y 34 UUNEX2070 0/1/2011 0/l/2012 EACH OCCURRENCE $1,000, 000 X COMMERCIALGENERALUABILITY CLAIMS -MADE 1XI OCCUR DAMAGE TC ROWED PREMISES IEa occurrence) $1, 000, 000 MED EXP(Any one person) $10,000 PERSONAL A ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $2,000,000 POLICY FI PRO FX7 LED Deductible $1,000 0 AUTOMOBILE LIABILITY y y 34UENEX2190 10/1/2011 0/l/2012 (Ea auitlenl) 1, 000, 000 X BODILY INJURY (Per person) $ ANY AUTO AOSCHEDULED AUTOS AUTOS e001LV INJURY (Per accident)$ X DAMAGE Per accident $ NONOWNEDPROPERTY HIRED AUTOS X AUTOS Is C X UMBRELLA LIAB X OCCUR Y Y 34 XHUEX19B0 10/1/2011 0/1/2012 EACH OCCURRENCE $8,000,000 AGGREGATE $8,000,000 EXCESS LIAB CLAIMS -MADE DED IX I RETENTION $10, 000 I$ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNEWEXECUTIVE OFFICERIMEMBER EXCLUDED? NIA y 618052 30/1/2011 0/1/2012 X WC STATU- OTH- RV R EL FAGH ACCIDENT $500, 000 E.L. DISEASE -EA EMPLOYE $500, 000 (Mandatory in NH) uY describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICYLIMIT $500,000 B Professional Liability 015449004 10/1/2011 0/1/201TPC15i. $2,000,000 Pollution Liability Aggregate $4,000,000 Claims Made DESCRIPTION OF OPERATIONS I LOCATIONS / 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; Designated Insured under 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 See Attached... City of Ft. Collins; Purchasing Division P.O. 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 All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC #: AC O® ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Van Gilder Insurance Corp. NAMED INSURED CTL/Thompson, Inc. 1971 W. 12th Ave. Denver CO 80204 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ISPl-111 L-1 Cr-14 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE for General Liability, Automobile Liability, Umbrella/Excess Liability and Workers' Compensation. Limit Contractual Liability is included. The Umbrella / Excess Liability policy provides excess coverage over the General Liability, Automobile Liability and Employers Liability. Additional Insured: City of Ft. Collins, Purchasing Division ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD