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HomeMy WebLinkAboutJUPITER I LLC DBA OFFICESCAPES - INSURANCE CERTIFICATEAC"Ro® CERTIFICATE OF LIABILITY INSURANCE DATE IMM/DDIYYYY) litl3/2/2012 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. Den r CC 8 p, 2 200 Denver CO 80202 NAMEp Client -Manage PNDNE Eat)303- 7- ac Ne:303-831-5295 nooaess:certificate y ic.com @ 9 INSURERS AFFORDING COVERAGE NAIC N INSURER A: L- t. Paul Fire & MarineIn INSURED JUPI INSURERB :HartfordInsurance Company -(MA Jupiter I, L.L.C. DBA: OfficeScapes - INSURERC: 9900 E 51 st Avenue Denver, CO 80238 INSURER D: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 728343168 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 rypE OF INSURANCE AD DL SUBR POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER MM/D D/YYYY MMIDDIYYYY LIMITS B GENERAL LIABILITY 59UENOC2298 3/1/2012 /1/2013 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES(Eaoccurrence $300,000 CLAIMS -MADE OOCCUR MED EXP(Any one person) $10,000 PERSONAL B ADV INJURY $1,000.000 GENERALAGGREGATE $2.000.000 GEMLAGGREGATE LIMITAPPLIESPER: PRODUCTS - COMP/OP AGG $2,000,000 X7 POLICY F-] PRO- n LOG $ B LIABILITY 59UENOC2299 3/1/2012 3/1/2013 IEa auAtlem) � $1,000,000 BODILY INJURY(Perperson)$ALL ANY AUTO OWNED SCHEDULEDBODILY AUTOAUTOS hAU10MOBILE INJURY (Per accident) $ PROPERI nDAMAGE $ HREDSAUTO S H NAUT-OWNED I Is I A X UMBRELLA LAB X OCCUR ZUP1 1S1 702012NF 3/1/2012 3/1/2013 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000.000 EXCESS LIAB CLAIMS -MADE DED IX I RETENTION$ 10,000 Follows Form I$ B WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY ITDRYLN1LiSANY $9WEOC2297 3/l/2012 3/1/2013 X WC STATD- EL.EACH ACCIDENT J $1,000,000 PROPRIETOR/PARTNERIEXECUTI, OFFICERIMEMBER EXCLUDED? N/A (Mandatory In NH) E.L. DISEASE -EA EMPLOYE$1,000,000 if yes, describe under DESCRIPTION OF OPERATIONS below - E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (Attach AGO RD 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 is included as Additional Insureds for ongoing and completed operations under General Liability, Automobile Liability, and Umbrella Liability. This insurance will apply on a primary, non-contributory basis. A Blanket Waiver of Subrogation applies for General Liability, Automobile Liability, Umbrella Liability and Workers' Compensation. Additional Insured: The City of Fort Collins, Colorado, a Municipal Corporation, its officers and employees The City of Fort Collins, a Municipal Corporation Attn: Director of Purchasing & Risk Management,PO 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 ' �T REPRESENTATIVE � �4�' Y © 1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD