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Home My WebLink About103885 COMPUTER SITES INC - INSURANCE CERTIFICATE (2)Client#: 52180 8COMPSIT ACORD,. CERTIFICATE OF LIABILITY INSURANCE O7/30/2/DDIYYYY) /30I2012 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 Willis of Colorado, Inc. 2000 South Colorado Boulevard Tower 11, Suite 900 Denver, CO 80222 CL CONTACT NAME: PHONE 303 722-7776 FAX, 303-722-8862 NC No, EX1: A/C No: E-MAIL ADDRESS: INSURER(5) AFFORDING COVERAGE NAIC V INSURER A: Valley Forge Insurance Company 20508 INSURED Computer Sites, Inc. 1225 South Huron Denver, CO 80223 INSURER B: National Union Fire Insurance O 14445 INSURER CPinnacol Assurance 41190 Continenaasua tl Casualty INSURER D: � Company 20443 Continental Insurance Company INSURER E: P Y 35289 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 CONTRACTOR 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 ADDLSUBR INSR _ MD POLICY NUMBER POLICY Err _(MMIDDIVYYY) POLICY EXP (MM/DDIYYYY)_ LIMITS A _ GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX OCCUR X G17957G 0101 4024840653 8/01/2012 08/0112013 EACH OCCURRENCE $110001000 GE TO RENTED DAMAPREMISES Ea occurrence s1,500,000 MEDEXP(Any one person) $5000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO POLICY X PRO- ECT �� LOC PRODUCTS - COMP/OP AGG $2,000,000 $ E AUTOMOBILEUABIUTY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIREDAUTOS X NON -OWNED AUTOS Olh Car 4024840636 8/01/2012 08/01/201 3 COMBINED SINGLE LIMIT (Ea accident) E 1,000,000 BODILY INJURY (Per person) $ 1X� BODILY INJURY (Per accident) $ PROPERTYDAMAGE$ Per acadenl XDrhre $ B X UMBRELLA LIAS EXCESS LIAR OCCUR CLAIMS -MADE BE03423676 8/01/2012 08/01/2013 EACH OCCURRENCE s10000000 AGGREGATE $10 000 000 DED I X I RETENTION$10000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEYIR OFPCEWMEMBER EXCLUDED? Y (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4107093 0810112012 08/01/201 X WCSTATU- OTH- TORYUMOS E.L. EACH ACCIDENT $1000000 E.L. DISEASE - EA EMPLOYEE1 $1 000 000 E.L. DISEASE - POLICY LIMIT $1,000,000 D Lease/Rented Equipment 6604756R580 8/01/2012 08101/2013 $350,000 Less Ded DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: 7081 Bridge Replacement -Whitcomb and Magnolia City of For Collins, Colorado SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O. BOX 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S955882/M955690 8RSMI G-17957-G (Ed.01/01) IMPORTANT: THIS ENDORSEMENT CONTAINS DUTIES THAT APPLY TO THE ADDITIONAL INSURED IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT. SEE PARAGRAPH CA- OF THIS ENDORSEMENT FOR THESE DUTIES. ALSO, THIS ENDORSEMENT CHANGES THE CONTRACTUAL LIABILITY COVERAGE WITH RESPECTS TO THE "BODILY INJURY" OR "PROPERTY DAMAGE" ARISING OUT OF THE "PRODUCTS -COMPLETED OPERATIONS HAZARD". SEE PARAGRAPH B.3. OF THIS ENDORSEMENT FOR THIS COVERAGE CHANGE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTOR'S SCHEDULED AND BLANKET ADDITIONAL INSURED ENDORSEMENT WITH LIMITED PRODUCTS -COMPLETED OPERATIONS COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL_ GENERAL LIABILITY COVERAGE PART Name of Person or Organization: SCHEDULE Designated Project; (Coverage under this endorsement is not affected by an entry or lack of entry in the Schedule above.) A. WHO IS AN INSURED (Section 0) is amended to 2. The Limits of insurance applicable to the include as an insured any person or organization, additional insured are those specified in the including any person or organization shown in the written contract or written agreement or in the schedule above, (called additional insured) whom you Declarations of this policy, whichever is less. are required to add as an additional insured on this These Limits of Insurance are inclusive of, and not policy under a written contract or written agreement; in addition to, the Limits of Insurance shown in the but the written contract or written agreement must be: Declarations. 1. Currently in effect or beanning effective during the term of this policy; and 2. Executed prior to the "bodily injury," "property damage; or "personal and advertising injury". B. The insurance provided to the additional insured is Omitod as follows: 1. That person or organization is an additional insured solely for liability due to your negligence specifically resulting from 'your work" for the additional insured which is the subject of the written contract or written agreement No coverage applies to liability resulting from the sole negligence of the additional Insured 3. The coverage provided to the additional insured by this endorsement and paragraph f. of the definition of Insured contracr under DEFINITIONS (Section V) do not apply to "bodily injury" or 'property damage' arising out of the .products -completed operations hazard' unless Ti quired b The written contract or written agreement When coverage does ap to "bodily r$u or "property damage' arising out of the "products -completed operations hazard' such Coverage will not apply beyond: a. The period of time required by the written contract or written agreement; or 6-17957-G Page 1 of 2 (Ed. 01/01)