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Home My WebLink About111694 TST INC SONSULTING ENGINEERS - INSURANCE CERTIFICATEACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 12/8/2011 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 Van Gilder Insurance Corp. 1515 Wynkoop, Suite 200 Denver CO 80202 N NAME: Kathy Star PHONE 7 FAXE231,303-83-8500 INC No: 1 295 E.NiAIL ADDREss:kstar v ic.com INSURERS AFFORDING COVE RAGE NAICk INSURER A:Hartford Insurance INSURED TSTCON III'/n 1' INSURERB:XL Specialty Insurancg Co. 37885 INSURERC:HARTFORD INS CO 37_478 HST, Inc. Consulting Engineers t 760 Whalers Way Building C, Suite 200 INSURER D: Fort Collins CO 80525 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 962554112 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 rypE OF INSURANCE ADDL INSR SUBR MD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDD/YYYY LIMITS A GENERAL LIABILITY Y Y 34SBAVS3417 12/1/2011 2/1/2012 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAG TOR NTED PREMISES Eaoccurrence $300,000 MED EXP(Any one person) $10,000 CLAIMS -MADE KOCCUR PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000.000 POLICY X PRO- LOC $ A LIABIUTY Y 34UEGPO2033 12/l/2011 2/1/2012 Ea accident 1.000,000 BODILY INJURY(Per persoAUTOS ANY AUTO ALL NED SCHEDULED POMOBILE BODILY INJURY (Per accident)HIRED AUTOS X AOT SWNED PPReOPPERd DAMAGE $ $ A X UMBRELLA LIAB X OCCUR Y 31SBAVS3417 12/1/2011 2/l/2012 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 EXCESS LIAB CLAIMS -MADE DED x I RETENTION$10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETORIPARTNERIEXECUTWE OFFICERIMEMBER EXCLUDED? N I A Y b4WEGIO8204 12/1/2011 2/1/2012 X %STATU- OTH- Y LIM E L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYE $1,000,000 (Mandatory in NH) If yes, describe under E.L. DISEASE -POLICY LIMIT I $1 000,000 DESCRIPTION OF OPERATIONS below B Professional Liability DPR9695292 12/1/2011 2/1/2012 Per Claim $1,000,000 Claims Made Annual Aggregate $1.000.000 DESCRIPTION OF OPERATIONS / 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 and Designated Insured under Automobile 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, Automobile Liability, and Workers' Compensation. Limited Contractual Liability is included. The Umbrella / Excess Liability policy provides excess coverage over the General Liability, Automobile Liability and Employers Liability. City of Fort Collins; Attn: James B. O'Neill II 281 N. College Avenue Fort Collins CO 80524 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 ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD All riahts reserved_