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HomeMy WebLinkAbout451613 EMPLOYERS EDGE LLC - INSURANCE CERTIFICATE (6)EMPLO-2 OP ID: TBD CERTIFICATE OF LIABILITY INSURANCE DAT04/30DIYYYY) F 04I30112 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 303-322-0800 CONTACT NAME: Steve BQII Madison Insurance Group 303-322-0874 425 S. Cherry St, #420 Denver, CO 80246 Thomas R Young PHONE 720-891-4901 FAX _(aq. No, Eat): _(NC, Nb E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC M INSURER A:Sentinel Insurance Company Ltd 11000 INSURED Employers Edge LLC I r f �1� 2755 S Locust St #119 U'> Denver, CO 80222 INSURER B: Hartford Insurance Company 0006 INSURER C INSURER D INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELPAI HAVE BEEN ISSUED T.n 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, 'HE 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 SUBR POLICY NUMBER POLICY EFF MMIDDIVVVV) POLICY E%P (MMIDD/YYYYL LIMITS B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X 34SBARV1642 � 06/01/12 ! I 06/01/13 EACH OCCURRENCE $ 2,000,000 11AMAGI EaN11 PREMISESoccurrence)$ 300,000 EXP (Any one person) $ 10,000 _MED i PERSONAL BADV INJURY $ 2,000,000 -- _ GENERAL AGGREGATE $ 4,000,000 � �GENL AGGREGATE LIMIT APPLIES PER. A POLICY FI PRO LOG PRODUGTS- DOMEIER AGG $ 4,000,000 $ B AUTOMOBILE 1 rat LIABILITY ANY AUTO ALL OWNED SCHEDULED !AUTOS AUTOS NONOWNEDPROPERTY HIRED AUTOS %t AUTOS 34SBARV1642II 06I01112 06/01/13 III COMBINED SINGLE LIMIT Ea accdent_ _ $ 1,000,000 INJURv (Per parson) $ ^BODILY BODILY INJURY( Per accident) $ DAMAGE '_Per acwenl_ $ $ I� UMBRELLA LIAB EXCESS LIAB OCCUR ' CLAIMSMADEAGGREGATE EACH OCCURRENCE $ $ I DED RETENTION$ _ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE ❑ OFFICERIMEMBER EXGLUOEDP !(Mandatory in NH) If ves deacdbe o^der DESCRIPTION OF OPERATIONS below INIA I WG STATU- OTH- TORV LIMITS. ER E.L. EACH ACCIDENT $ E.L. DISEASE EA EMPLOYEE! -- — $ -------- _ EL DISEASE- POLICY LIMIT 1 $ 7 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule. if more space is required) City of Fort Collins is included as Additonal Insured with respect to General Liability of the Name Insured SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ft. Collins ACCORDANCE WITH THE POLICY PROVISIONS. Purchasing Division 215 N Mason, 2nd Floor AUTHORIZED REPRESENTATIVE Ft Collins, CO 80522 ���pr '7_ l"�,,_,{c�✓ © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD EMPLO-2 OF ID: TBD A�Ro CERTIFICATE OF LIABILITY INSURANCE DATE04/30DIYYYY) r 4/30/12 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 303-322-0800 CONTNAME ACT Steve Bell Madison Insurance Group 303-322-0874 425 S. Cherry St, #420 Denver, CO 80246 Thomas R Young PRONE 720-891-4901 FAX _IAIC, No,Exq.INCNo): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: Sentinel Insurance Company Ltd 11000 INSURED Employers Edge LLC 2755 S Locust St #119 INSURER B: Hartford Insurance Company 0006 Denver, CO 80222 INSURER c 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 SUER POLICY EFF I POLICY NUMBER MMIDDIYYYV ' POLICY EXP MMIDDIYYVV LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,00 B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X 34SBARV1642 06/01/12 06/01/13 DAMA ET RENT D PREMISES La occurrence) $ 300,000 MED EXP(My one person) $ 10,000 PERSONAL&ADV INJURY $ 2000,000 _ GENERAL AGGREGATE 4,000,00 it GEN'L AGGREGATE LIMIT APPLIES PER . --�.— PRO - f_—,. X ,I POLICY LOC I PRODUCT COMP/OP AGO I$ $ 4,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO I 34SBARV1642 06/01112 j 06/01/13 I COMBINED SINGLE LIMIT ' JEa acadenll 1 $ 1,000rOOO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS HIREDAUTOS X NON -OWNED AUTOS X �—� BODILY INJURY (Peraccidenp $ PROPERTY DAMAGE Per accitlant $ $ UMBRELLA LIAR OCCUR I EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR 1 MAINS -MADE ; 'I j DED RETENTIONS $ I WORKERS NSATION AND EMPLO ERSELIA ILIITY VIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ NIA TORV IMIT OTR E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE] $ (Mandatory in NH) If Fes tlescritle under D—SCRIPTION OFOPERATIONS heln�u _ EI_DLSFA$E-PIIi ICY I,I "IT — ,i I I I i I � I I I III DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is rectums) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ft. Collins ACCORDANCE WITH THE POLICY PROVISIONS. Purchasing Division 215 N Mason, 2nd Floor AUTHORIZED REPRESENTATIVE Ft Collins, co 80522 `, �,7. � k/ etC U 1966-2U10 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD