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113275 ALLER-LINGLE-MASSEY ARCHITECTS PC - INSURANCE CERTIFICATE (9)
OP ID: SK1 ,a►�oRo CERTIFICATE OF LIABILITY INSURANCE DAT12/12DYYYY) 12/12/12 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 endorsements . PRODUCER 970-223-1804 Front Range Insurance Group _ 1100 HaXton Drive Suite 100 Fort Collins, CO 80525 - David A. Wooldridge LUTCFAAI 'S ' CONTACT PHONE FAX A/C No Eat : AIC No): ADE-DRESS:MAIL PRODUCER CUSTOMER ID p:ALLER-1 INSURERS AFFORDING COVERAGE NAIC d INSURED Aller-Lingle-Massey Architects, P.C. 712 Whalers Way, Suite B-100 Ft. Collins, CO80525 INSURER A:PInnacol Assurance 41190 INSURER B: The Hartford 30104 INSURER C:RLIInsurance Company INSURER D : ISURER E NSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 15 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 rypE OF INSURANCEADDLSUBR POLICY NUMBER POLICY EFF MM/DDIYYYY) POLICY EXP (MMIDDfYYYYI LIMITS GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX-1 OCCUR X 34SBA KJ7716 DX 04/09/12 04/09/13 EACH OCCURRENCE $ 1,000,00 _15B PREMISES Eaoccur.ence $ 300,00 MED EXP (Any one person) $ 10,00 PERSONAL B ADV INJURY $ 1,000,00 X EPLI$5,000 GENERAL AGGREGATE $ 2,000,00 GEN'LAGGREGATE LIMITAPPLIES PER', X POLICY PRO LOC PRODUCTS - COMP/OP AGO $ 2,000,00 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 34UECIQ8390 04/09/12 04/09/13 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Peraccident) $ X X $ $ B UMBRELLA LIAB EXCESS UAB X OCCUR CLAIMS -MADE 34SBA KJ7716 DX Oa109H2 O4I09113 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ DEDUCTIBLE ERTENTIO$ 10000 $ $ A WORKERS COMPENSATION AND EMPLOYERS' MBIUTY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 1951272 04/01/12 04/01/13 X WC STATU- OTH- E.L. EACH ACCIDENT $ 500,00 E.L. DISEASE - EA EMPLOYEE $ 500,00 E.L. DISEASE -POLICY LIMIT $ 500,00 C Prof. Liability RDP0008980 12/14112 12/14/13 Per Claim 2,000,00 Aggregate 2,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more Space Is required) The liability. City of Fort Collins is named additional insured with regards to general CERTIFICATE HOLDER CANCFI I ATH IN CITY OF ------------- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Purchasing Division PO BOX 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 ACORD 25 (2009109) 01988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD OP ID: SKI A�ORO° CERTIFICATE OF LIABILITY INSURANCE DAT12/12DYYYY) 12/12/12 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 endorsements . PRODUCER 970-223-1804 Front Rangelnsurance Group 1100 Haxton Drive Suite 100 Fart Collins, CO'80525 David A. Wooldridge LUTCFAAI NAME'CT - PHONE - FAX ac No Ext: JAIC, No): E-MAIL PRODUCER CUSTOM" ID,:ALLER-1 INSURERS AFFORDING COVERAGE NAIC P INSURED Aller-Lingle-Massey Architects, P.C. 712 Whalers Way, Suite B-100 Ft. Collins, CO 80525 INSURERA:PinnacalAssurance 41190 INSURER 8:The Hartford 30104 INsuRERc:RLI Insurance Company 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. ILTR TYPEOFINSURANCE POLICYNUMBER MMIOD/YEYYY /Y MMIDDPLICY YYY LIMITS B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FXI OCCUR X 34SBA KJ7716 DX 04/09112 04I09/13 EACH OCCURRENCE $ 1,000,00 PDREMISES E. occurrence $ 300,00 MED EXP (Any one person) $ 10,00 PERSONAL S ADV INJURY $ 1,000,00 X EPLI$5,000 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMITJFCT APPLIES PER: X POLICY . PRO_ RO LOC PRODUCTS-COMP/OP AGG $ 2,000,00 $ B AUTOMOBILE LIABILITY .ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 34UEC108390 04109/12 04109113 COMBINED SINGLE LIMIT" (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Peraccident) $ X X $ $ B UMBRELLA LIAR EXCESS LIAR X OCCUR CLAIMS -MADE 34SBA KJ7716 DX 04109112 04I09113 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ DEDUCTIBLE RETENTION $ 10000 $ X $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTI,S F OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 1951272 04/01/12 04/01113 X WC STATU- OTH- E.L. EACH ACCIDENT $ 500,00 E.L. DISEASE -EA EMPLOYEE $ 500,00 E.L. DISEASE -POLICY LIMIT $ 600,00 C Prof. Liability RDP0008980 12114112 12/14/13 Per Claim 2,000,00 Aggregate 2,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ANach ACORD 101, AddlUonal Remarks Schedule, If more space Is required) South Transit Center. The City of Fort Collins is named as an additional insured with regards to general liability. CERTIFICATE HOLDER r.ANr.FI I eTInN CITY OF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins ty PO Box 580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE ACORD 25 (2009/09) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD