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113275 ALLER-LINGLE-MASSEY ARCHITECTS - INSURANCE CERTIFICATE
OP ID: JA ,a�coRo CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDOIYYYY) 12/16/11 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($), 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 . PRODUCERNAME970-223-1804 Front Range Insurance Group 1100 Haxton Drive Suite 100 Fort Collins, CO 80625 David A. Wooldridge LUTCFAAI CONT:CT PHONE FAX MC No Ext, ac No: E-MAIL ADDRESS: PRODUCER .gLLER-1 CUSTOM UST ME D . INSURERS AFFORDING COVERAGE NAG INSURED Aller-Lingle-Massey INSURER A: PInnacol Assurance 41190 Architects, P.C. INSURER e: The Hartford 712 Whalers Way, Suite B-100 Ft. Collins, CO 80525 INSURERC: RLI Insurance Company INSURER 0: 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 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 POLICY NUMBER MWDD/YYYY MM/DD/YV YY LIMITS B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X _ ,- 34SBA KJ7716 DX - - 04/09/11 04/09/12 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ 300,00 MED EXP (Any one person) $ - 10,00 PERSONAL & ADV INJURY $ 1,000,00 X EPLI $5,000 GENERALAGGREGATE $ 2,000,00 GENT AGGREGATE POLICY LIMIT APPLIES PER - X JECTPRO_ RO LOC PRODUCTS-COMP/OP AGG $ 2,000,00 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTO$ HIRED AUTOS NON -OWNED AUTOS 34UECIQ8390 04/09/11 04/09/12 COMBINED SINGLE LIMIT (Ea aoolden) $ 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (PeraccitlenU $ $ B UMBRELLA LIAR EXCESS LIAR X OCCUR CLAIMS -MADE 34SBA KJ7716 DX 04I09111 04/09112 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ DEDUCTIBLE RETENTION $ 10,000 $ X $ A WORKERS COMPENSATION AND EMPLOYER$' LIABILITY ANY PROPRIETORPARTNERtEXECUTIVE Y OFFICERIMEMBER EXCLUDED? (Mandatory m NH) If yes, do=ibe ..tier DESCRIPTION OF OPERATIONS halo« NIA 1951272 04/01/11 04/01/12 X WC STATU- OTH- E.L. EACH ACCIDENT $ 500,00 E.L. DISEASE - EA EMPLOYEE $ 500,00 E.L. DISEASE - POLICY LIMIT $ 500,00 C Prof. Liability RDP0005714 12/14/11 12/14/12 Per Cliam 2,000,00 Aggregate 2,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If mom space Is required) The City of Fort Collins is named additional insured with regards to general liability. _ CERTIFICATE HOLDER CANCELLATION CITY OF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Purchasing Division ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 �� C. �. c%rr�i(++ ACORD 25 (2009/09) ©1988.2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD OP ID: JA ACORO° CERTIFICATE OF LIABILITY INSURANCE DATDYYVY) 112/162/16111 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 tc the certificate holder in lieu of such endorsements . PRODUCER 970-223-1804 Front Range Insurance Group 1100 Haxton Drive Suite 100 Fort Collins, CO 80525 David A. Wooldridge LUTCFAAI CONTACT PHONE FAX INC. No Ext : INC, N0: E-MAIL ADDRESS: PRODUCER ALLER-1 T M"IDa: CUSTOM" INSURERS AFFORDING COVERAGE NAIC R INSURED Aller-Lingle-Massey Architects, P.C. 712 Whalers Way, Suite B-100 Ft. Collins, CO 80525 INSURERA: PInnacol Assurance 41190 INSURER B:The Hartford INSURERC:RLI Insurance Company 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 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 UB POLICY NUMBER ,POUCY/YEFF MM CY EXP LIMITS B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY ' CLAIMS -MADE 150 OCCUR - X 34SBA KJ7716 DX - - 04/09111 04/09112 EACH OCCURRENCE $ 11000,00 PREMISESEHLNILD $ 300,00 MED EXP (Anyone person) ' $ 10,00 PERSONAL B ADV INJURY $ 1,000,00 X EPLI$5,000 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: 17 POLICY X PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,00 $ B AUTOMOBILE LIABILITY AN Y AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-0WNED AUTOS 34UECIQ8390 04I09/11 04I09/12 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ B UMBRELLA UAB EXCESSLIAR 7X OCCUR CLAIMS -MADE 34SBA KJ7716 DX 04109111 04109112 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ DEDUCTIBLE RETENTION $ 10,000 $ X $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N /A 1951272 04101/11 04101112 X WC STATU- OTH- Y11 E.L. EACH ACCIDENT $ 500,00 E.L. DISEASE - FA EMPLOYEE $ 600,00 E.L. DISEASE - POLICY LIMIT $ 600,00 C Prof. Liability RDP0005714 12114/11 12114/12 Per Cliam 2,000,00 Aggregate 2,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Ramerka Schedule, If mom space Ia required) South Transit Center. The City of Fort Collins is named as an additional insured with regards to general liability. CERTIFICATE HOLDER CANCELLATION CITY OF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522 AUTHORRED REPRESENTATIVE ACORD 25 (2009109) 01988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD