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HomeMy WebLinkAbout465444 SPIRAE INC - INSURANCE CERTIFICATE (2)UP IU: 1 L ,a►��Ro CERTIFICATE OF LIABILITY INSURANCE 09/05/2013 09/OS/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 endorsements . PRODUCER Phone:970-635-9400 CONTACT PFS Insurance Group -JT Fax: 970-635-9401 4848 Thompson Pkwy, Ste 200INC,No Johnstown, CO 80534 John HInlZman - � PHONE FAX Ext): INC, No): EMAIL -ADDRESS! PRODUCER SPIRA-1 CUSTOMER ID. p: INSURER(S) AFFORDING COVERAGE I NAICif INSURED Spirae, Inc. INSURERA:Chubb Insurance Group 141386 Spirae. DK ApS INSURER B : Pinnacol Assurance Co 141190 243 N College AVe Fort Collins, CO 80524 INSURER C INSURER 0 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ImiSo INSR TYPE OF INSURANCE N)'l SUBRI POLICY NUMBER MMIOOY/YYYY MMLDDIYYYV LIMITS LTR A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR 3593-71-28 .3593-71-28 OBI31I2013 08/31/2013 08I3112014 08/31/2014 EACH OCCURRENCE DAMAGE TO RENTED — PREMISES Ea occurrence) $ 1,000,000 $ 500,00 MED EXP (Any one person) Is 10,00 PERSONAL BADV INJURY $ 1,000,00 X Professional GENERAL AGGREGATE 8 GENL AGGREGATE LIMIT APPLIES PER'. X POLICY FI PRO LOC PRODUCTS - COMP/OP AGO$ 2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 7356-37-47 08/31/2013 08/31/2014 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ I $ A X X HDEDUCTIBL UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS -MADE RETENTIONE $ 7988 1928 08/31/2013 08/31/2014 EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,00 Is B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCWDED9 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4151157 10/01/2013 10/01/2014 WC STATU- �OTH- X TORV LIMIT$ ER_ ELEACH ACCIDENT $ SDD,DDD E. L. DISEASE - EA EMPLOYEES 500,000 E.L. DISEASE -POLICY LIMIT 1 $ 500,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) If required by written contract or written agreement, the certificate holder is included as additional insured for ongoing operations under general liability. CITYFCI City of Fort Collins Attn: Risk Management 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 © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD