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Home My WebLink About503976 DESIGNSCAPES COLORADO - INSURANCE CERTIFICATE (2)DESIG-3 OP ID: LIZ 1441c"�szo' CERTIFICATE OF LIABILITY INSURANCE DAT12126/nvvr) /26/12 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 303-799-0110 Cherry Creek Ins. Agency, Inc. Suite 500 303-799-0156 5660 Greenwood Plaza Blvd. Greenwood Village, CO 80111 Steven L. Doss I CONTACT Gail Clark PRONE FAX AIc Nn Ea:720-212-2056 (ac 1 303-799-0156 E-MAIL ADDRESS: GailC@thinkccig.com INSURERS AFFORDING COVERAGE INSURER NAIL If INSURER A: Westfield Insurance 24112 INSURED Colorado Designscapes, Inc. INSURER B: Pinnacol Assurance 41190 dba Designscapes Colorado 15440 E Fremont Drive NSURER C: Centennial, CO 80112 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 TR TYPE OF INSURANCE ADDL BURR POLICY NUMBER MMIDDNYYY ICY EXP MMLDDIYVVV LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE j OCCUR X X CMM5484560 11/01/12 11/01/13 DAMAGE TDRENTED PREMISES Ea occurrence $ 300,00 MED I (Any one person) $ 15,00 PERSONAL BADVINJURY It 1,000,00 X Limited Pollution $1000000/$2000000 GENERALAGGREGATE $ 2,000,00 GENE AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG $ 2,000,00 POI PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,00 X BODILY INJURY (Per person) 1$ A ANY AUTO X X CMM5484660 11/01/12 11/01/13 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident)$ HIRED AUTOS NON -OWNED AUTOS PROPERTY -DAMAGE Per accident $ $ 1 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 5,000,00 AGGREGATE $ 5,000,00 A EXCESSLIAB CLAIMSMADECMM5484560 11/01/12 11/01/13 DED X RETENTION$ 10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICER/MEMBER EXCLUDED' (Mandatory in NH) N I A 4051150 01/01/13 01/01/14 WC STATU- OTH- X TOR, O LIMITS ER AD. E.L. EACH ACCIDENT $ 1,000,00 EL E-I EMPLOYEE $ 1,000,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,00 A Leased/Rented Eq CMMS484560 11/01/'12 11/01/13 Rent/Leas 500,00 A Installation Float CMM5484560 11/01/12 11/01/13 IM Float 100,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) RE: 7362 Radiant Neighborhood Park AS required by written contract or written agreement, The City of Fort Collins and its officers and employees are included as Additional Insured with Waivers of Subrogation in favor of the Additional Insured, under General Liability and Automobile Liability. City of Fort Collins 300 Laporte Avenue 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. AUTHOR�IZED REPRESENTATIVE r `"5""""'EDJ 1988-2010 ACORD CORPORATION. All rights reserved ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD