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Home My WebLink About398304 LAREL HILL GIS INC - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE F DATE(MMIDDIYYYY) 03/14/2012 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 endorsement(s). PRODUCER CONTACT NAME: Ewing -Leavitt Insurance Agency Pn"Ic°NN Eat: 970.679.7333 uC Nq).866-456.4265 4025 St. Cloud Dr. E-MAIL ADDRESS: Suite 100 h Loveland, CO 80538 U PRODUCER 00002465 CUSTOMER ID N: INSURER(S) AFFORDING COVERAGE NAICM INSURED INSURER A: Assurance Company of America 19305 LAUREL HILL GIS INC. INSURERB: Pinnacol Assurance 41190 307 BROSS ST INSURER : Lloyds of London 15792 LONGMONT, CO 80501-5427 INSURER D: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 12/13 master 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 SUER WVD POLICY NUMBER POLICY EFF MM0IDONYYY POLICY EXP MMIDDIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I X I OCCUR PPS037575108102/0112012 02/01/2013 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrencgl $ 1,000,000 MED EXP Any one person) $ 10,000 PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY JECPRO- LOC PRODUCTS - COMPIOP AGG $ 2,000,00 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLAU a EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ S B WORKERS COMPENSATION AND EMPLOYERS'LABILIITY YIN OFFICER/MEM ER EXCLUDED ANY ECUTIVE� (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 409179604/01I2012 04I01I2013 TH- X TORY IMITS ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 C Errors & Omissions USUCS26447201 10I26/2011 10I26I2012I $1,000,000 Each Claim $2500 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) UCRI lr IUAI IM nULUMM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins Attn: John Stephens AUTHORIZED REPRESENTATIVE PO BOX 580 Fort Collins, CO 80522 Katie Klimpk/KAMo All Hants reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD