HomeMy WebLinkAbout439705 BELFORD WATKINS GROUP LLC - INSURANCE CERTIFICATE (5)ACORO® CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD YYYY)
3/13/2012
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
NTA
NAME: Nancy Roman
P"DCT
_EX
NE 303-837-8500 AIC -,:303-831-5295
Van Gilder Insurance Corp.
1515 Wynkoop, Suite 200
Denver CO 80202
EJ.tAIL
ADDRESS:nroman@ygc.com
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INSURER(S) AFFORDING COVERAGE NAIC If
INSURERA:XL Sporialty Insurance
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INSURED BEL WAT
INSURER B
INSURERC:
Belford Watkins Group, LLC
PO Box1306
Fort Collins CO 80522
INSURER D:
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 791027072 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 ADDL SUBR POLICY EFF POLICY EXP
LTR INSR WVD POLICY NUMBER MMIDD MM/DO/YYYY LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$
DAMAGE TO R NNTED
COMMERCIAL GENERAL LIABILITY
PREMISES Ea occurrence
$
CLAIMS -MADE DOCCUR
MED EXP(Any one person)
$
PERSONAL B ADV INJURY
$
GENERALAGGREGATE
$
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$
POLICY PRO LOC
$
AUTOMOBILE
LIABILITY
Ea accident
BODILY INJURY (Per person)
$
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per accident(
$
PROPERTY DAMAGE
Per accident
$
NON -OWNED
HIRED AUTOS AUTOS
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
❑ED 1 1 RETENTION$
$
WORKERS COMPENSATION
WCsTATU- OTH-
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNERIEXECUTIVE❑
EXCLUDED?
NIA
EL EACH AOFFICERIMEMSER CCIDENT
$
E.L. DISEASE- EA EMPLOYE
$
(Mandatory in NH)
If yes, describe under
E.L. DISEASE- POLICY LIMIT 1
$
DESCRIPTION OF OPERATIONS below
A
Professional Liability
bPS9699167
3/15/2012
3/15/2013
$1,000,000 Per Claim
Claims Made
$1.000,000 Annual Aggregate
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
LelakillirgllLl
City of Fart Collins
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
ACORD 25 (2010/05)
The ACORD name and logo are registered marks of ACORD
All rights reserved.