HomeMy WebLinkAbout490870 STATERA INC - INSURANCE CERTIFICATE"✓,b® CERTIFICATE OF LIABILITY INSURANCE
DATE
9/5/2012YYYI
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
Schwander Insurance Services, LLC
558 E. Castle Pines Pkwy
Suite B4 ; PMB 405
Castle hock CO 80108
CNOAME: NTACAna T AHoldren
_
PHONE (303) 658-0800 FACNO
AE-pmpgLESS,ana@schwanderinsuranoe.com
INSURERS AFFORDING COVERAGE
NAIC a
INSURER A:Travelers Property Casualty Co.
25674
INSURED 1�QO610
Staters, Inc. L{' ) �f
6501 E. Belleview Ave, Suite 300
Englewood CO 80111
INSURERB:The Travelers Indennit Company
5658
INSURERC:Hartford Insurance Group
INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBERCL129500200 REVISION NUMBER: 1 : New Policy$a
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
WP OF INSURANCE
SUOR
POLICY NUMBER
MAWL
WOCY EFF
MPwLIDCY UPLIMITS
GENERAL LIABILITY
EACH OCCURRENCE
f 1,000,000
X COMMERCIAL GENERAL LIABILITY
PREMISES a nenm
f 500, 000
A
CLAIMB-MADE OCCUR
2LP14S44240
6/1/2012
6/1/2013
MED UP(Any me nwn)
$ 10,000
PERSONAL S ADV INJURY
f 1,000,000
GENERAL AGGREGATE
f 2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGO
S 2,000,000
$
PRO El LOC
X. POLICY JECT
AUTOMOBILE LIABILITY
CEOaMBBIINOED SINGLE LIMIT
11000,000
BODILY INJURY (Per person)
$
X ANY AUTO
B
BODILY INJURY (Peraxitleld)
$
ALL OWNED SCHEDULED
Ba1490RO12
6/1/2012
6/1/2013
AUTOS AUTOS
I
PROPERTY DAMAGE
Perecodent
$
NON-0VINED
HIRED AUr05 AUTOS
f
X
UMBRELLA LIAR
:{
OCCUR
r"
EACH OCCURRENCE
$ 5,000,006
A
SS LUIB
CLAIMS -MADE
ZUP14SSOOSO
6/1/2012
6/1/2013
AGGREGATE
f 5,000,000
7X I RETENTIONS 10,00
$
C
WORKERS COMPENSATION
X WC STATU- GTH-
ANDEMPLOYERS' UABILIW YIN
ANY PROPRIETORIPARTNER/ ECUTIVE
E.L. EACH ACCIDENT
S 11000,000
OFFICERIMEMBER EXCLUDED?
(Mantlatory In NH)
NIA
34WBCBJ4334
1/1/2012
1/1/2013E.L.
DISEASE - EA EMPLOYE
S 11000,000
If yes, desalbe uncer
DESCRIPTION OF OPERATIONS bel.
E.L. DISEASE -POLICY LIMIT
$ 1,000,000
A
Technology Errors S
2PL14S44252
6/1/2012
6/1/2013
Eacl Wrongful Ad $5,000,000
Omissions Liability
Policy Aggregate $5,000,000
DESCRIPTION OF OPERATIONSI LOCATIONS I VEHICLES (Attach ACORD 101, Atldhlmal Rewern; Schedule, If owns apace le re9ulnsd)
The City of Fort Collins is listed as an Additional Insured, under General Liability only, with respects
to their interest in work performed by the insured as per written specified contract.
City of Fort Collins
215 North Mason
P. O. Box 580
Fort Collins, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Schwancier/ANA
INS025 (?moos, n1 The ArtnRn .erase end Inn. ens ro.ief.roA ,nedre of arnRn