HomeMy WebLinkAbout212187 WEATHERSURE SYSTEMS INC - INSURANCE CERTIFICATE (9)WEATH-5 OP ID: LIZ
CERTIFICATE OF LIABILITY INSURANCE
DAT07/03DrvYYY)
07103/13
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 endomement(s).
PRODUCER 303-799-0110
CONTACT
Ginny Shaw
Cherry Creek Ins. Agency, Inc.
Suite500 303-799-0156
5660 Greenwood Plaza Blvd.
Greenwood Village, CO 80111
PHONE Fax
ac No EXt1720-330-7903 (A/y_Ne); 303-799-0156
E-MAIL
ADDRESS: Ginnl(S@thinkccig.com
Steven L. Doss
INSURERS AFFORDING COVERAGE
NAIL N
INSURER A: National Fire Insurance Co.
I (�
4 11 0
INSURED WeatherSUre Systems Inc
INSURER B: Allmerica Financial Benefit
3333 S Platte River Drive
Englewood, CO 80110
INSURER : National Union Fire Ins Co PA
INSURER D:PinnacolAssurance
41190
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: REVISIONNUMBER:
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.
LTR
TYPE OF INSURANCE
ADO
SUaII POLICY NUMBER
MMIDO YVVV
MMIDDIYYYY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,00
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
X
5093389063
07/01113
07I01114
TO RENT D
PRDAMAGEEMISES Ea occurrence
$ 100,000
MED EXP(Any one person)
$ 5,00
PERSONAL B AOV INJURY
$ 1,000,00
GENERAL AGGREGATE
$ 2,000,00
GEN'L AGGREGATELIMIT APPLIES PER:
PRODUCTS - COMPIOP AGO
$ 2,000,00
POLICY A PRO LOG
n
$
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
BODILY INJURY (Per person)
$
B
X ANY AUTO
AW4877561804
07/01/13
07/01/14
AOSCHEDULED
AUTOS AUTOS
BODILY INJURY (Per accident)
$
NON -OWNED
HIRED AUTOS AUTOS
PROPERTY DAMAGE
Per accident
$
$
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 5,000,00
X
AGGREGATE
$ 5,000,00
C
EXCESS LIAB
CLAIMS -MADE
BE031942307
07/01/13
07/01/14
DED I X I RETENTION$ O
$
D
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
AN V PROPRIETOR/PARTNER/EXECUTIVE YIN
OFFICERIMEMBER EXCLUDED?
N/A
3471401
07/01/13
07/01/14
X WE STATU- OTH-
T RY LIMIT E.
EL. EACH ACCIDENT
$ 1,000,00
EL. DISEnSE-EA EMPLOYEE
S 1,000,00
(Mandm., in NH)
It yes, describe under
DESCRIPTION OF OPERATIONS Celrnv
EL DISEASE - POLICY LIMIT
I $ 1,000,00
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
RE: 6064 Civic Center & Old Town Parking Garage
As required by written contract or written agreement, the Certificate Holder
is included as Additional Insured under General Liability.
City of Fort Collins
Attn: James B. O'Neill 11
PO Box 580
215 N. Mason St., 2nd Floor
Ft. 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
U 19BU-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD