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Home My WebLink AboutINTELLISOURCE LLC - INSURANCE CERTIFICATEACORDT, CERTIFICATE OF LIABILITY INSURANCE 9/lYL013 DATEIMMID YYYY) 9/4/2012 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 Lockton Companies, LLC Denver 8110 E Union Avenue Suite 7DD Denver CO 80237 (303)414-6000 CONTA NAME: CT PR X AID, No Ezt : A No E-MAIL ADDRESS: INSURER AFFORDING COVERAGE NAICA INSURER A: The Charter Oak Fire Insurance Company 25615 INSUREDI IntelliSouree, LLC 1344046 1899 Wynkoop Street, Suite 900 Denver, CO 80202 INSURERS: Travelers Property Casualty Co of Amenc 25674 INSURER C: XL Specialty Insurance Commanv 37885 INSURER D: The Travelers Indemnity Co of America 25666 N URER ' N R COVERAGES INT0000 23701ERTIFICATE NUMBER: 11963814 REVISION NUMBER: XXXXXXX THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TOERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUER NND POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDD/YYYY 6HE LIMIT A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY X�OCCUR N N 630-5A570042-COF-12 9/1/2012 9/1/2013 EACH OCCURRENCE 00X PREMISESOEa ouorr0ence 00CLAIMS-MADE MEO EXP An one erson PERSONAL B ADV INJURY $ 1000000 GENERAL AGGREGATE s 2,000,000 GEN'L AGGREGATE 7 POLICY LIMIT APPLIES PER. F7 JECT 7 LOG PRODUCTS - COMPIOP AGO S 2000000 $ D AUTOMOBILE LIABILITY ANY AUTO ALL AUTOS AUTOS HIRED AUTOS AUTOS ED N N BA-5A570042-12-TEC 9/1/2012 9/1/2013 COMBINED t SINGLE LIMIT $ 1,000,000 X BODILY INJURY (Per person) $ XXXXXXX BODILY BODILY INJURY (Per accident $ XXXXXXX (Per accciden DAMAGE $ XXXXXXX $XXXXXXX B }( UMBRELULIAB EXCESS LIAR X OCCUR CLAIMS -MADE N N CUP-5A570042-TIL-12 9/1/2012 9/1/2013 EACH OCCURRENCE $ 4 ODD 000 AGGREGATE $ 41000,000 DED I I RETENTION $ 1 $ XXXXXXX C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECOTIVE YIN OFFIOER/MEMSER E CLDDEDP N❑ (Mandatory in NH) II yes. "Iunder DESCRIPTION OF OPERATIONS below NIA N RWD5000337 9/1/2012 9/1/2013 VJC $TATU- DTH- X TORY LIMITS EL EACH ACCIDENT $ 11000,000 E. L. DISEASE - EA EMPLOYEE 1,000,000 E.L DISEASE - POLICY LIMIT 1000000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES /(Attach ACORD 101, Additional Remarks Schedule, if more space is required) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 11963814 AUTHORIZED REPRESENTATIVE City of Fort Collins Purchasing Division 215 N. Mason St., 2nd Floor P.O. Box 580 Fort Collins, CO 80522 aele 161/ ACORD 2512010/O51 n19AA nln ACORn CORPn) ATIr1N All Hnht. ro..rvs.d The ACORn n... and Innn a. r.ni.*.rod mark. of ACORn