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HomeMy WebLinkAbout103885 COMPUTER SITES INC - INSURANCE CERTIFICATE (3)Client#: 52180 SCOMPSIT ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATErYYYY) OB/021202/2013 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 CONTACT NAME: Willis of Colorado, Inc. PHONE 303 722-7776 FAX °' Est); ac, No : 303-722.8862 2000 South Colorado Boulevard E Mal Tower ll, Suite 900 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC It Denver, CO 80222 p INSURER A, Valley Forge Insurance Company 20508 INSURED INSURER B: Continental Casualty Company 20443 Computer Sites, Inc. INsuRERc:Pinnacol Assurance 41190 1225 South Huron INSURER D: Travelers Property Casualty Com 36161 Denver, CO 80223 INSURER E: Continental Insurance Company 35289 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR MD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MMIDDIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMSMADEaOCCUR 4024840653 8/01/2013 08/01/2014 EACH OCCURRENCE $1 000,000 DAMAGE TO RENTED PREMISES Ea occurrence $1,500000 MED EXP(Any one person) $5,000 PERSONAL It ADV INJURY $1,000,000 GENERALAGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO X LOC JECT PRODUCTS-COMP/OPAGG $2,000,000 $ E AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS N AUTOS XDdve Out Car 4024840636 0810112013 08101/2014 COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTYDAMAGE Per accident $ $ B X UMBRELLALIAB EXCESS LIAR X OCCUR CLAIMS -MADE 4030406096 8/01/2013 08/01/2014 EACH OCCURRENCE $10000000 AGGREGATE $1 O 00O 000 DED X RETENTION $1 O 000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below NIA 4107093 8/0112013 08101/201 X WC STATU- OTH- TQRY MIT ER E.L. EACH ACCIDENT $1 000,000 E.L. DISEASE -EA EMPLOYEE $1 000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 D Lease/Rent Equip OT6604756R580TIL13 8/01/2013 08/01/2014 $350,000 less Ded DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: 7081 Bridge Replacement - Whitcomb and Magnolia City of For Collins, Colorado 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 ACORD 25 (2010/05) 1 of 1 #S1052493/M1052470 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ETBEC