The URL can be used to link to this page

Home My WebLink About439705 BELFORD WATKINS GROUP LLC - INSURANCE CERTIFICATE (6)Allstate. You're In pod hands. ALLSTATE INSURANCE COMPANY RENEWAL DECLARATIONS CUSTOMIZER POLICY NO. 050 818845 SPECIAL FORM 1. The Insured BELFORD WATKINS GROUP LLC Mailing Address PO BOX 1306 FORT COLLINS, CO 80522 LOCATION OF INSURED PREMISES: 231 S HOWES ST FORT COLLINS, CO 80521 MASONRY OFFICE 2. Policy Period from 07/08/2012 to 07/08/2013 Beginning and ending Standard Time at the address of the insured stated above. 3. The Insured is a CORPORATION 4. ADDITIONAL INTERESTS This policy also covers the interests of any of the following when indicated by "X" and named below. ................... The Mortgagee'under> The Loss Payee'under El Other Coverage A Part One Coverage A -, Part Two El The Additional Insured El The Vendor under for Leased Premises, Coverage B - Part One under Coverage, B - Part One Name SEE BU5575-3' Address 5. POLICY COVERAGES This policy applies to each of the Coverages and Parts shown below. Under Coverage A, Coverage is provided only for property at the Insured Premises for,which a specific limit of liability is shown. Coverage A - Business Property Part Limits of Liability One Buildings The Property lnsurance Adjustment Condition IS NOT applicable to this policy Two Business Contents REPLACEMENT COST $57, 000 DEDUCTIBLE $250 applicable to each adjusted loss Coverage B - Business Liability Part Limits of Liability One Comprehensive Liability $2, 000, 000 EACH ACCIDENTAL EVENT Fire and Specified Peril Legal Liability $50,000 EACH ACCIDENTAL EVENT Advertising Injury Liability 0100, 000 Two Medical Payments $5, 000 EACH PERSON $25,000 EACH ACCIDENT BU5570-7 (Ed. 1-08) Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 1 of 4 BU114R-3 ®Allstate. You're In good funds. RENEWAL DECLARATIONS CUSTOMIZER POLICY NO. 050 818845 SPECIAL FORM 6. OPTIONAL COVERAGES The following optional coverages, if any, are provided under this policy. Coverage Location(s) Limits of Liability ADDITIONAL INSURED ALL SEE COVERAGE B - PART 1 EMPLOYER NON -OWNER AUTO LIABILITY ALL SAME AS COVERAGE B - PART 3 HIRED AUTO ALL SEE COVERAGE B - PART 4 7. Annual Premium for the Policy and Optional Coverages $513. 00 The portion of the annual premium shown above that is attributable to coverage for losses caused by "acts of terrorism" to which the Program established by the Terrorism Risk Insurance Act, as amended, applies is $0-COVERAGE REJECTED. SEE DISCLOSURE NOTICE ON PAGE 4 OF 4. BU5570-7 (Ed. 1-08) Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 2 of 4 BU114R-3 ®Allstate. You re in good Mnde. RENEWAL DECLARATIONS 8. ENDORSEMENTS The following endorsements amend this policy. BU5575-3 BU5550A BU5598-7 BU5766 BU5767 BU5795 BU5695 BU5728 BU5741 PROCESS DATE: 05/16/2012 RCC: WE Countersigned by JAMES E COMER INC. BU5570-7 (Ed. 1-08) CUSTOMIZER POLICY NO. 050 818845 SPECIAL FORM BU5754 BU5756-1 BU5562 BU5780-1 BU7504 Authorized Agent Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 3 of 4 BU114R-3 ®Allstate. You',e In gmd Nods. RENEWAL DECLARATIONS CUSTOMIZER POLICY NO. 050 818845 SPECIAL FORM POLICYHOLDER DISCLOSURE NOTICE OF TERRORISM INSURANCE COVERAGE The federal Terrorism Risk Insurance Act, as amended, (the federal Act), establishes a temporary federal Program (the federal Program) providing for a system of shared public and private compensation for certain insured commercial property and casualty losses resulting from "acts of terrorism." as defined in the federal Act. The federal Act defines an "act of terrorism" as an act that is certified by the Secretary of the Treasury, in concurrencewiththe,Secretary of State, and ,the Attorney General of the United States, to be an act of terrorism; to-be'a,'violent act or an act that,is dangerous to human life, property, or d --infrastructure;-to-have-resulted in-amage- within -the -United-States,-or- outside -of- the -United -States --------- in the case of certain'air carriers or vessels or on,the.premises of a United States mission; and to have been cornmitted,by>an individual or individuals, as a part of an effort to coerce the civilian population,of the United States or to influence4h,d policy or affect the conduct of the United States Government by coercion. A DISCLOSURE OF FEDERAL SHARE OF COMPENSATION FOR INSURED LOSSES Insured losses caused by "acts of terrorism" to which the federal Program applies would be partially reimbursed by the United States of America under a formula established by the federal Act. Under that formula, the United States of America pays 85 percent of covered terrorism losses exceeding the statutorily established deductible paid by the insurance company providing the coverage. If aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act, as amended, exceeds $100 billiomin a Program Year (January 1 through December 31) and we have met our insurer deductible under the Terrorism Risk Insurance Act, as amended, we shall not be liable for the payment of any portion of the amount of.such losses that exceeds $100 billion, and in such case insured losses up'go that amount are subject to pro rata'allocatioh in accordance with procedures established,by.the�Secretary of -the -Treasury: i DISCLOSURE OF PREMIUM `` [X] Your insurancecoverage does, not include coverage for losses caused by "acts of terrorism" to which the federal Program applies. ,Accordingly, the portion of your, annual premium that is attributable to coverage for losses caused by "acts of terrorism" to -which the federal Program applies is $0.00. If you would like your insurance coverage to include coverage for losses caused by "acts of terrorism" to which the federal Program applies (subject to policy terms, conditions, limitations and exclusions), you- may purchase that coverage for an additional annual premium charge of $1.00 . Please ask your agent for more information. BUSS7a7 (ED. 01-08) Page 4 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. BU114R-3 Allstate. You're in good hands. SPECIAL FORM CUSTOMIZER POLICY NO. 050 818845 SUPPLEMENTAL DECLARATIONS 4. ADDITIONAL INTERESTS This policy covers the interests of any of the following when named below. The Mortagee, under Coverage A - Part One, the Loss Payee under Coverage A - Part Two, the Additional Insured under Coverage B - Part One, and the Vendor, under Coverage B - Part One. Loc. No. Bldg. No. Additional Interest Name & Address 002 001 ADDITIONAL INSURED CITY OF LOVELAND LIBRARY ADDITION 105 W 5TH ST LOVELAND, CO 80537 i 002 001 LOSS PAYEE GREAT AMERICA, LEASING CORPORATION �P O BOX.609 CEDAR'RAPIDS, IA 52406-0609. i 002 001 ADDITIONAL INSURED GREAT AMERICA LEASING CORPORATION P O BOX 609 CEDAR RAPIDS, IA 52406-0609 002 001 ADDITIONAL INSURED CITY OF LOVELAND, FT COLLINS-LOVELAND AIRPORT JET,CENTER VESTIBULE ADDITION (SEE BU7504) 4824 EARHART RD LOVELAND, CO 80538 002 001 ADDITIONAL INSURED CITY OF FORT COLLINS, PO BOX 580 FORT COLLINS, CO 80522 002 001 ADDITIONAL INSURED COLORADO STATE UNIVERSITY FACILITIES SERVICE CENTER NORTH 200 W LAKE ST FORT COLLINS, CO 80521-4593 BU5575.3 Page 1 BU114R3 ®Allstate. Y.,.i.,� hh &. Coverage B - Business Liability ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION SCHEDULE' Name of Person or Organization OF FORT COLLINS PERSONS INSURED is amended to include as a person insured the person or organization shown in the above Schedule as a person insured but only with respect to liability arising out of your op- erations or premises owned by or rented to you. 'Information required to complete the Schedule, if not shown on this endorsement, will be shown in the Declarations. BU5695 (Ed. 1-85) Page 1 of 1 BU114R-3 Allstate. Y.m.me dh.,& CHANGE MANUSCRIPT FORM BU7504 IT IS HEREBY AGREED THAT THE ADDITIONAL INSURED FORM BU5695 COMPLETE NAME READS AS FOLLOWS: CITY OF LOVELAND, FT COLLINS-LOVELAND AIRPORT JET CENTER VESTIBULE ADDITION AND ENTRY LANDSCAPING 4824 EARHART RD LOVELAND CO 80538 Page 1 of 1 BU116R-3