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Home My WebLink About457580 J F SATO & ASSOCIATES - INSURANCE CERTIFICATEACORO® CERTIFICATE OF LIABILITY INSURANCE GATE (MMIDD YYYY) Ill.i12/15/2011 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 CONT CT NAME: Kathy t r Van Gilder Insurance Corp. 1515 Wynkoop, Suite 200 Denver CO 80202 PHONE :30 -837- 0 uc N.3- 31-5 5 E-MAIL ADDRESS:ks-ta,r,@y4ic.com INSURERS) AFFORDING COVERAGE NAIC4 INSURERA:H rtf rd Insurance G INSURED INSURERB:XL Specialty Insurance Co 3 INSURERC: .885 J. F. Sato & Associates, Inc. 5878 S. Rapp Street Littleton CO 80120 INSURER D: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1179855103 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 TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDOIYYYY LIMITS A GENERAL LIABILITY Y Y '34SBWN09598 12/24/2011 2/24/2012 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE IT] OCCUR DAMAGE RETE PREMSESOEa occurence $300,000 MED EXP(My one person) $10,000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGO $2,000,000 POLICY X PRO- n LOD $ A AUTOMOBILE LIABILITY Y Y 34SBWN09598 12/24/2011 12/24/2012 Eaacrident 1,000,000 BODILY INJURY (Per person) 1 $ ANY AUTO ALL OS SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS X AUTOS IS A X UMBRELLA LIAB OCCUR Y Y 34SBWN09598 12/24/2011 2/24/2012 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 EXCESS LIAB CLAIMS -MADE DED x RETENTION$ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N I WCSTATU- OTH- T RV LIMIT ER ANY PROPRIETCRIPARTNERIEXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? NIA E.L. EACH ACCIDENT $ E.L. DISEASE- EA EMPLOYE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ B Professional Liability DPR9691181 T11812011 /18/2012 Per Claim $1,000,000 Claims Made Annual Aggregate $2,000,000 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, 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 for General Liability, Automobile Liability and Umbrella/Excess Liability/ Limited Contractual Liability is included. The Umbrella / Excess Liability policy provides excess coverage over the General Liability and Automobile Liability. Additional Insured: City of Fort Collins City of Fort Collins, Purchasing PO 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 lld/�� @ 1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD