HomeMy WebLinkAbout456216 JKG CONSULTING INC - INSURANCE CERTIFICATEACORq CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDDIYYYY)
06/19/2013
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
Ewing -Leavitt Insurance Agency
402S St. Cloud Dr.
Suite 100 j
Loveland, CO 80538 IVY
NAME:
kH NN E>R:970.679.7333 ac.N:866.456.4265
IC
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAICY
INSURER A: Endurance American Specialty
41718
INSURED JKG Consulting Inc.
3767 Carrington Rd.
Fort Collins, CO 80525
INSURERS: Pinnacol Assurance
41190
INSURER C:
INSURER D:
INSURER E :
INSURER F:
COVERAGES CERTIFICATE NUMBER: 13-14 REVISION NUMBER:
THIS IS TO CER I IFY I HAT THE POLIcirs OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE
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
LTp
TYPE OF INSURANCE
INSR
WVD
POLICY NUMBER
MLVDOr YYY
Mi&DD YYY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
FEIECC15984-0
06/12/2013
06/12/2014
EACH OCCURRENCE
$ 1,000,0
PREMISES (Ea mcurmwe)
It 50,00
MED EXP (Any one Person)
$ 5,00
PERSONAL AADVINJURY
$ 1,000,00
GENERAL AGGREGATE
$ 2,000,00
GEN'L AGGREGATELIMIT APPLIES PER:
POLICY JRC LOC
PRODUCTS-COMP/OP AGO
$ 2,000,00
$
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
HIRED AUTOS AUTOS
Ee eo:ident)
$
BODILY INJURY (Par person)
$
BODILY INJURY (Perauidern)
$
(Per accident)
$
UMBRELLA LAB
EXCESSUAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
DED I I RETENTIONS
$
B
WORKERSCOMPENSATION
ANDEMPLOYERS'LUIBILITY YIN
ANY OFFICERIMEMBERIEXCLUDED?ECUTIV
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS bebw
NIA
412655
09/01/2012
09/01/2013
TORY LIMBS ER
E.L.EAGHACCIDENT
8 100,00
E.L DISEASE - EA EMPLOYEE
$ 100,00
EL DISEASE-POUCY LIMIT
$ S00 00
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Anach ACORD 101, Additional Remarks Schedule, if more apace is required)
E: Consulting Services
FAX: 970.221.6619
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Fort Collins AUTHORIZED REPRESENTATIVE
P 0 Box 580
Fort Collins. CO SOS22 Fhrhalla 7rn'ronn,
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD