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Home My WebLink About439705 BELFORD WATKINS GROUP LLC - INSURANCE CERTIFICATE (8)ACOR" CERTIFICATE OF LIABILITY INSURANCE OA/210 M/DDP/YYY) 3/12/2013 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 endomement(s). PRODUCER Van Gilder Insurance Corp. 1515 Wynkoop, Suite 200 Denver CO 80202 CONT CT NAME: Nan Cy-ROman PHONE Ext 3 7-8500 N.);303-831-5295 - 2 E-MAIL s:nroman v ic.com @ g- INSURER(S) AFFORDING COVERAGE NAICIf INSURER A:XL SpeCialty Insurance o. 37885 `-� '—Irl BELWAT INSURED INSURER B:CLSentinel Insurance _Company 1100-0 Belford Watkins Group, LLC INSURER C: PO Box 1306 Fort Collins CO 80522 INSURER D: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 1859835903 REVISION NUMBER:1 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 I POLICY EFF MMIDOIYYYY POLICY EXP MM/DD/YYYY LIMITS B GENERAL LIABILITY Y Y 34SBAPM7802 4/8/2012 /8/2013 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx ] OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $1,000,000 MED EXP(Any one person) $10,000 PERSONAL& ADV INJURY $1,000,000 GENERAL AGGREGATE $2.000,000 GEN, AGGRE�GATE LIMIT APPLIES PER'. PRODUCTS - COMPIOP AGG $2,000,000 JECT POLICY I^ PRO n LOC $ B AUTOMOBILE LIABILITY Y Y 34SBAPM7102 %/8/2012 /8/2013 COMBINE DEa accitlent $1,000,000 BODILY INJURY (Per person) $ ANY AUTO ALL OVONEDAUTOSSCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X PR PeOPERT n DAMAGEr am $ HIRED AUTOS x AUTOSWNED B X UMBRELLALIAB X OCCUR Y 34SBAPM7102 7/8/2013 EACH OCCURRENCE 81,000,000 AGGREGATE $1,000,000 EXCESS LIAR CLAIMS -MADE �/8/2012 DED X RETENTION$10,000 $ WORKERS COMPENSATION ANDEMPLOYERTLIABILinY/N ANY PROPRIETOR/PARTNERIEXECUTIVE❑ OFFICER/MEMBER EXCLUDED? NIA wC STATU- OTH- YLIMIT ACH ACCIDENT $ rE.L.ISEASE-EA EMPLOYE $ (Mandatory in NH) If yes, desctlbe under DESCRIPTION OF OPERATIONS below ISEASE-POLICY LIMIT $ A Professional Liability N Y DPS9707159 /15/2013 /15/2014 $1,000,000 Per Claim Claims Made $1.000,000 Annual Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) As required by written contract or written agreement, the following provisions apply subject to the policy terms, conditions, limitations and exclusions: The Certificate Holder and Owner are included as Additional Insureds for ongoing and completed operations under General Liability; Designated Insured under Automobile Liability; and Additional Insured under Umbrella / Excess Liability but only with respect to liability arising out of the Named Insured's work performed on behalf of the certificate holder and owner. This insurance will apply on a primary, non-contributory basis. A Blanket Waiver of Subrogation applies for General Liability, Automobile Liability and Umbrella/Excess Liability. Limited Contractual Liability is included. The Umbrella / Excess Liability policy provides excess coverage over the General Liability and Automobile Liability. City of Fort Collins 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. AUTHORIZED REPRESENTATIVE 1988.2010 ACORD CORPORATION. All riahts reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ACORO® CERTIFICATE OF LIABILITY INSURANCE YYYY) 3/DATE12/2013 13 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 N TACT NAME: Nan Cy_R4man Van Gilder Insurance Corp. PHONE 7-85 a/c Ne:-831-5296 1515 Wynkoop, Suite 200 E-MAIL Denver CO 80202 v i s:nroman@gis com INSURER(S) AFFORDING COVERAGE NAICO INSURER A:XL Specialty Insurance h7885 INSURED BELWAT INSURER B:CL Sentinelli-surancei Compa_n 1000 Belford Watkins Group, LLC INSURER C: PO Box 1306 INSURER D: Fort Collins CO 80522 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 220131840 REVISION NUMBER:1 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 rypE OF INSURANCE ADDL I.SR SUBR WVD POLICY NUMBER POLICY EFF MMIO DNYYY POLICY EXP MM/DD/YYYY LIMITS B GENERAL LIABILITY Y Y 34SBAPM7802 7/8/2012 /8/2013 EACH OCCURRENCE $1,000000 x COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1XI OCCUR DAMAGE TO RENTED PREMISES RENT rrence $1,000,000 MED EXP(Any one person) $10,000 PERSONAL B ADV INJURY $1,000000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGG $2,000,000 POLICY I^ PRO F LOC $ B AUTOMOBILE LIABILITY Y Y 34SBAPM7802 /8/2012 /8/2013 Ea accident) $1,000,000 BODILY INJURY (Per person) $ ANY AUTO AOLED AUTOS AUTOS BODILY INJURY (Per accident) $ x PR PeOPERTaccident)DAMAGE $ �AUT08SCHED HIRED AUTOS x AUTOSOWNED $ B X UMBRELLALIAB X OCCUR Y ,Y 34SBAPM7802 7/8/2012 /8/2013 EACH OCCURRENCE $1,000,000 AGGREGATE $1, 000,000 EXCESS LIAB CLAIMS -MADE DED x RETENTION$10,000 IS WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNEPo XECUTIVE WC STATU- OTH- TORYIM E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED' NIA E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) It yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ A Professional Liability N Y DPS9707159 111512013 /15/2014 $1,000,000 Per Claim Claims Made $1,000,000 Annual Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) As required by written contract or written agreement, the following provisions apply subject to the policy terms, conditions, limitations and exclusions: The Certificate Holder and Owner are included as Additional Insureds for ongoing and completed operations under General Liability; Designated Insured under Automobile Liability; and Additional Insured under Umbrella / Excess Liability but only with respect to liability arising out of the Named Insured's work performed on behalf of the certificate holder and owner. This insurance will apply on a primary, non-contributory basis. A Blanket Waiver of Subrogation applies for General Liability, Automobile Liability and Umbrella/Excess Liability. Limited Contractual Liability is included. The Umbrella / Excess Liability policy provides excess coverage over the General Liability See Attached... tRq:u atnaf�aiL9 �IR3i:1 City of Fort Collins 215 N Mason 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 (C) 1QRR.2n1n ACnRn Cr1RPnPATInN All einhfc ACORD 25 (2010/06) The ACORD name and logo are registered marks of ACORD