HomeMy WebLinkAbout113275 ALLER-LINGLE-MASSEY ARCHITECTS PC - INSURANCE CERTIFICATE (10)OP ID: CR
. hh O CERTIFICATE OF LIABILITY INSURANCE
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DAT03/28YYYY,
03/28/13
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: It the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WANED, 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 endorsemen s -
PRODUCER 970-223-1804
NAME
Front Range Insurance Group
1100 Haxton Drive Suite 100
Fort Collins, CO 80525
David A Wooldridge LUTCFAAI
ll
Z i
PHONE
Arc Na,
OR
PR ucE
c ALLER-1
INSUR 9 AFFORMNG COVERAGE
NAC0
INSURED Aller-Lingle-Massey
INSURER A: PInnacol Assurance
41190
Architects, P.C.
712 Whalers Way, Suite B-100
Ft. Collins, CO 80525
INSURERS: RLIInsurance Company
INBURER C:
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,
EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFF
M
POLICY EXP
MIDD
UNITS
GENERALLUUNUTY
EACH OCCURRENCE
S 1,000,00
B
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE X❑ OCCUR
X
PSB0003168
04/09113
04/09114
PREMISES E
S 1,000,0
MED EXP M . )
$ 10,00
X EPLI 10K
PERSONAL SADV INJURY
$ 1,000,00
GENERALAGGREGATE
5 2,000,0
GENL AGGREGATE
LIMIT APPLIES PER:
PRODUCTS-COMPIOPAGG
$ 2,000,00
X POLICY
P'FrITRO- LOC
Em . Ben.
s 500,00
B
AUTOMOBILE
LIABILITY
ANY AUTO
PSA0001167
04109/13
D4/09114
COMBINED SINGLE LIMIT
(Esa Ikrt)
S 100000
,,
BODILY INJURY(Pe, pwa )
f
ALL OWNED AUTOS
BODILY INJURY(Per accidaM)
S
SCHEDULED AUTOSPROPERTY
HIREDAUTOS
IX
DAMAGE
(Per Is= e )
S
5
NON-OWNEDAUTOS
$
X
UMBRELLA LUU)
X
OCCUR
EACH OCCURRENCE
$ 1,000,00
AGGREGATE
S
B
EXCESS LIAR
CIAIMS-MADE
PSE0003007
04/08/13
04/09/14
$
X1DeoucneLE
T
S
RETENTION 10000
A
WORKERS COMPENSATION
EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE YIN
OFFCERIMEMBER EXCLUDED? El
NIA
1951272
04/01/13
O4/01114
X WC STATU- FUR-'
E.L. EACH ACCIDENT
S 500,00
E. L. DISEASE - EA EMPLOYE
$ 500,00
(Mandatory In NN)
H Yee, cia.tx under
OE RIPTIONOf OPERATIONS 0ebw
1E.L.
DISEASE -POLICY LIMIT
3 500,9
B IProf.
Liability
RUP0008980
12/14/12
12114/13
Per Claim 2,000,00
Aggregate 2,000,00
DESCRIPTON OF OPERATIONS I LOCATIONS I VEHICLES (ABach ACORD 101, A ItNr al Re,nerlu Se I, Nm m aPaca Is
The Citp of Fort Collins is named additional insured with regards to general
liability.
CITY OF
City of Fort Collins
Purchasing Division
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.
AUTHOFUEED REPRESENTATNE
®1988-2009 ACORD CORPORATION. All rights
ACORD 26 (2009109) The ACORD name and logo are registered marks of ACORD
OP ID: CR
ACQ^ Q�
CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIODNYYY)
03/28113
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(les) 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 endorsemen s .
PRODUCER 970-223-1
Front Range Insurance Group
1100 Halton Drive Suite 100
Fort Collins, CO 80525
David A. Wooldridge LUTCFAAI
N ME:
PHONE
A/C N0:
EMAIL .
PRODO R ALTER4
INSURE 8 AFFORDING COVERAGE
NAILS
INSURED Aller-Lingle-Massey
Architects, P.C.
712 Whalers Way, Suite B-100
Ft. Collins, CO80525
INSURER A:PinnacolAssurance
41190
INSURERS: RLIInsurance Company
wsURERD:
INSURER D
INSURER!:
"
NSURERr:
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
TYPE OP INSURANCE
POLICY NUMBER
MID(VYY
lwomufficnyEXp
LIMITS
GENERAL WIe1LRY
EACH OCCURRENCE
$ 1,000,00
B
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 7XOCCUR
X
PSB0003168
04l09/13
04l09H4
p Ea n=,.M,
f 1,000,00
MED EXP( ono, person)
$ 10,00
PERSONAL &ADV INJURY
If 1,000,0
X EPLI 10K
GENERALAGGIEGATE
f 2,000,00
GEN-L AGGREGATE
LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG
S 2,000,00
X POUCY
PRO LOC
Em .Ben.
f 500,00(
B
AUTOMOBILE
I)ABILITY
ANY AUTO
-
PSA0001167
04/09/13
04/09114
COMBINED SINGLE LIMIT
(e°aodaem)
$ 1,000,00
X
BODILY INJURY(Pef pwmo)
S
ALL OWNED AUTOS
BODILY INJURY(Pw ectlCaM)
$
SCHEDULED AUTOS
HIRED AUTOS
X
PROPERTY DAMAGE
(Pw eci0e,0)
f
X
NON -OWNED AUTOS
1
S
,X
UMBRELLA LIAR X OCCUR
EACH OCCURRENCE
S 11000100
-
AGGREGATE
$
B
"Cass UPS CLAIMSIUADE
---------- —
PSE0003007
04/09/13
04/09/14
S
DEDUCTIBLE
X
RETE14TION S 10000
S
A
WORKERS COMPENSATION
AND EMPLOYERS' WIB UL
ANY PROPRIETORIPARTNERIEXECUTNE YONN
OFFICER) MBER EXCLUDED?
(Ma,Wabry In NH)
fir Oeaaibe wMar
DESCRIPTION OF OPERATIONS below
NIA
-
1951272
04/01M3
04/01/14
_
X WC STATU' OTH-
E.L. EACH ACCIDENT
f 500100
E.L DISEASE - EA EMPLOYEE
f 500,00
E.L DISEASE -POUCY LIMIT
f 600,00(
B
Prof. Liability
ROPOOO8980
12/14/12
17JI4113
Per Claim 2,000,00(
Aggregate 2,000,00
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach no=101, AOe .I Mmarfa S Wa, M m0n spew la ra9°NaC)
South Transit Center. The City of Fort Collins is named as an additional
insured with regards to general liability.
CITY OF
City of Fort Collins
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
C 1988.2009 ACORD CORPORATION. All riahts reserved
ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD