HomeMy WebLinkAbout500474 INTEGRENOMICS - INSURANCE CERTIFICATER CERTIFICATE OF LIABILITY INSURANCE
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D/10/ 201DD/Y2
810/2
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 endorsements .
PRODUCER
BOLT Insurance Agency
10 Waterside Drive
Suite 202
Farmington CT 06032
CONTACT
Kevin Rodrigues
PHONEExit. (800)216-4171 FAX o. (860)777-2621
AD AIL .krodrigues@boltinsurance..com
RESS
INSURERS AFFORDING COVERAGE
NAIC #
INSURERA:HiSCOX Insurance Company, Inc.
10200
INSURED �a0 L,14
Integrenomics
508 BIG HORN DR
ESTES PARR CO 80517
INSURER B:
INSURER C :
INSURER D:
INSURER E
INSURERF:
COVERAGES CERTIFICATE NUMBER:CL1281028BOO REVISION NIIMRFR-
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
A
S
POLICY NUMBER
MM DIDmYY)
(MM/DDIYYYYI
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
C-1290861-CGL-12
/10/2012
/10/2013
DAMAGE RENTED
PREMISES Ea occurrence
$ 100,000
MED EXP(Any one person)
_
$ 10,000
PERSONAL 8 ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS- COMP/OP AGG
$ Included
X POLICY PRO LOC
$
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident
BODILY INJURY (Per person)
$
ANY AUTO
_
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY Per accident
( )
$
NON -OWNED
HIRED AUTOS AUTOS
PROPERTY DAMAGE
Per accide 0
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAR
CLAIMS -MADE
DED I ETENTION$
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y I N
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
OFFICER/MEMBER EXCLUDED?
N/A
WC STATU- OTH-
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
$
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT 1
$
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is required)
Amended certificate
City of Fort Collins
300 LaPorte Ave
Fort Collins, CO 80521
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
Rodrigues/GIORIO
v Taste-ZWU AGORU CORPORATION. All rights reserved.
INS025 (201005).01 The ACORD name and logo are registered marks of ACORD