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Home My WebLink About398304 LAUREL HILL GIS INC - INSURANCE CERTIFICATE (3)~`'""" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) O1/31/2013 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 CONTACT NAME: Katie Klimek Ewing -Leavitt Insurance Agency PN"0"oE,t:970.679.7375 �uD"e),866.372.4617 EMAIL ADDRESS: katie-klimek@leavitt.com 4025 St. Cloud Dr. Suite 100 PRODUCER 00002465 CUSTOMER ID 11 Loveland, CO 80538 INSURER(S) AFFORDING COVERAGE NAICN INSURED INSURER A: Assurance Company of America 19305 LAUREL HILL GIS INC. INSURER : Pinnacol Assurance 41190 307 BROSS ST INSURER : Lloyds of London 15792 LONGMONT, CO 80501-5427 INSURER D: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 13/14 master 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 rypE OF INSURANCE ADDL INSR SUBR WVD POLICY EFF POLICY NUMBER MMIDD,YYYY POLICY EXP MMILOIE YY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR PPS037575108' 02101/2013 02/01/2014 EACH OCCURRENCE $ 1,000,00 DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000, DD MED EXP (Any one person) $ 10, 000 PERSONAL& ADV INJURY $ GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC JECT PRODUCTS - COMP/OP AGG $ 2,000,00 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ A J( UMBRELLA LIAR EXCESS LIAB X I OCCUR CLAIMS -MADE PPS037575108102/0112013 02101/2014 EACHOCCURRENCE $ 1,000,00 AGGREGATE $ 1,000,000 DEDUCTIBLE RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N OANY R((E ECUTIVE❑ FFICEOPRIETEREART (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 409179604/01/2012 04101/2013 X TORV LIMITS ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE- EA EMPLOYEE $ 1,000,000 E.L. DISEASE- POLICY LIMIT $ 1,000,000 C Errors & Omissions USUC5264472012i1012612012 10/2612013 $1,000,000 Aggregate $1,000,000 Each Incident DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more Space In required) MCR I IfIVIiI C RVLI/CR City of Fort Collins Attn: John Stephens PO BOX 580 Fort Collins, CO 8OS22 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Fill] I.DIZIP' AIl3ll44W,in in"Jal reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD