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Home My WebLink About398304 LAUREL HILL GIS INC - INSURANCE CERTIFICATE (4)A /+AAA MVVR6/ CERTIFICATE OF LIABILITY INSURANCE F DATE(MMMDIYYYY) 03/14/2013 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 Alc°Ne Eaf): 970.679.7375 uC Ne):866.372.4617 4025 St. Cloud Dr. Suite 100 .+1 Loveland, CO 80538 L/., G E-MAIL ADDRESS: katie-klimek@leavitt.com PRODUCER 000OZ465 CUSTOMER ID in INSURER($)AFFORDING COVERAGE NAIC# INSURED INSURER A: Assurance Company of America 19305 LAUREL HILL GIS INC. INSURERB: Pinnacol Assurance 41190 307 BROSS ST INSURER : Lloyds of London 85202 LONGMONT, CO 80S01-5427 INSURER D: INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: 13/14 Master Revised 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 LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDDIYYri POLICY EXP MMIDD/YYNY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F_x1 OCCUR PP503757510802101/2013 02/0112014 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO - ECT PRODUCTS - COMPIOP AGO $ 2,000,00 $ AUTOMOBILE 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 (Par accident) $ PROPERTY DAMAGE (Per accident) S $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE PPS03757510910210112013 02/01/2014 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ 1,000,000 DEDUCTIBLE RETENTION $ $ I $ B WORKERS COMPENSAERS'LIATIOIN YIN AND ANY OFFICERMEM ER EXCLUDED? PROPRIETORIPARTNERIEXECUTIVE❑ (MIf yandatory, In NH) DESCRIPTION OF OPERATIONSbelow NIA 409179 04101/2013 04/01/2014 X TORYLIMITS ER E.L. EACH ACCIDENT $ 1, 000, QQQ E.L. DISEASE - EA EMPLOYE $ 1, 000, 00 E. L. DISEASE -POLICY LIMIT $ 1, 000, 00 C Errors & Omissions USUCS264472012 10/26/2012I10126/2013 $1,000,000 Each Incident $1,000,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) City of Fort Collins Attn: John Stephens PO 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. AUTHORIZED REPRESENTATIVE Katie Kli ©1988.2009 ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD reserved.