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HomeMy WebLinkAbout132158 CTL/THOMPSON INC - INSURANCE CERTIFICATE (21)® DATE IMMIDDIYYYY) oRo CERTIFICATE OF LIABILITY INSURANCE g„5„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 endorsementls). PRODUCER ✓an Gilder Insurance Corp. 1515 Wynkoop, Suite 200 Denver CO 80202 INSURED CTL/Thompson, Inc. 7306 S. Alton Way Centennial CO 80112 COVERAGES CERTIFICATE NUMBER: 1909157R93 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 L TYPE OF INSURANCE A L INSR POLICYNUMBER POLICY EFF POLICY EXP MWDD/YYYY LIMITS D GENERAL LIABILITY Y V B802C991762 10A/2013 0/1/2014 EACH OCCURRENCE $1.000000 X COMMERCIAL GENERAL LIABILITY$1,000,000 MED EXP (Any ore, arson) $10000 CLAIMS -MADE X-1 OCCUR PERSONAL B ADV INJURY $1.000,000 GENERAL AGGREGATE $2,OD0,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,OD0000 s POLICY X PRO- LOC D AUTOMOBILE LIABILITY Y 8101175R522 0/12013 0/1/2014 Ea aaidmt 1000000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) It ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS X AUTOS PROPERTY DAMAGE Per accident $ S C X UMBRELLA UAB X OCCUR Y CUP3C002974 0/1/2013 0112014 EACH OCCURRENCE s8AD0,000 AGGREGATE $8.000,000 EXCESS LIAR CLAIMS -MADE DED X I RETENTION S10.000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER4EXECUTIVE YIN OFFICER/MEMBER E%CLUDED7 N❑ (Mandatory in NH) NIA y 518062 ON2013 101112014 X VYCSTATLINI,U- OTH- E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE $500,000 E.L. DISEASE-POLICY LIMIT 5500000 If re, describe under DE SCRIPTION OF OPERATIONS below B Professional and Pollution Liability 0112013 0/12014 Per Claim $2,000.000 Annual Aggregate $4,000,000 Claims Made �LSUPRO26233613 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ARMch ACORD 101. Additional Remarks Schedule, If more space Is required) As required by written contract or written agreement, the following provisions apply subject to the policy terms, conditions, limitations and exclusions: The Certificate Holder and Owner are included as Additional Insureds for ongoing and completed operations under General Liability; Designated Insured under Automobile Liability; and Additional Insured under Umbrella / Excess Liability but only with respect to liability arising out of the Named Insured's work performed on behalf of the certificate holder and owner. This insurance will apply on a primary, non-contributory basis. A Blanket Waiver of Subrogation applies for General Liability, Automobile Liability, Umbrella/Excess Liability and Workers' Compensation. Limited Contractual Liability is included. The Umbrella / Excess Liability policy provides excess coverage over See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ft. Collins, Purchasing Division ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 580 Fort Collins CO 80522 AUTHORIZIED � ACORD 2512010105) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC #: ACo ® ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Van Gilder Insurance Corp. NAMED INSURED CTUThompson, Inc. 7306 S. Alton Way Centennial CO 80112 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE the General Liability, Automobile Liability and Employers Liability. Additional Insured: City of Ft. Collins, Purchasing Division CCnRn tDt r2nORlOt1 n 2008 ACORD CORPORATION. All riahts reserved. The ACORD name and logo are registered marks of ACORD