Loading...
HomeMy WebLinkAbout525323 XYBIX SYSTEMS INC - INSURANCE CERTIFICATEClient#: 561986 XYBISYST2 ACORD,,., CERTIFICATE OF LIABILITY INSURANCE 1 D 9126/126/22/DD/YYYY) 013 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 NAME' Bobbi McGee HUB International Ins Svcs Inc PH AC No ONE Ect: 720-207-2363 ,vc No), 866-243-0727 1125 17th Street, Suite 900 AoDRREB$: bobbi.mcgee@hubinternational.com Denver, CO 80202 INSURER(5)AFFOROINGCOVERAGE NAIC• 866 795-0300 . Chador (ta4 Fim Ina uran�s rnm 75R15 INSURED EINSURER B: Travelers Indemnity Companyvv� 25658 tjY17 XybixX Systems, Inc. dba bix Systems Inc. INsuaeac: Travelers Casualty Insurance Co 19046 INSURER O: 8207 Southpark Cr INSURER E Littleton, CO 80120 INSURER FCA License #0757776 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. LTR TYPE OF INSURANCE IINSR WUVBIR D POLICY NUMBER MM/DDY EPP MM/DDY EXP LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS-MADEIF—VI OCCUR 6809A168195 0/01/2013 10101/2014 EACH OCCURRENCE $1000000 PREMISES EaEoi,Ertence E3OO OOO MED EXP (Any one person $1 O 000 PERSONAL S ADV INJURY $1 00O 000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PEOT LOC PRODUCTS-COMP/OP AGO $2,000,000 $ C AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS BA9A17253A 0/0112013 111111101/2014 EOMBINNEEDSINGLE LIMITacc 1,000,000 X BODILY INJURY (Per peson) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Peracddent $ 8 B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CUP9A180971 0/01/2013 1010V2014 EACHOCCURRENCE $5000000 AGGREGATE $5 00O OOO DED I X I RETENTION $5 000 E B WORKERS COMPENSATION AND EMPLOYERS' UABILm' OFFICEOPRIE ER E%CLUDERE? ECUTIVE� (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS Wluw N /A UB5D77490413 0/01/201310/01/201 X WCSTATU- OTH- ER E.L. EACH ACCIDENT $1 00O 000 E.L. DISEASE -EA EMPLOYEE $1000000 E.L. DISEASE - POLICY LIMIT $1 000000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Project: Dispatch Center Work Stations CityOf Fort Collins Transfort Bus Div. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN David Carey, CPPB City ACCORDANCE WITH THE POLICY PROVISIONS. of Fort Collins Purchasing 6570 Portner Rd AUTHORIZED REPRESENTATIVE Fort Collins, CO 80525 6 ``J ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) 1 Of 1 The ACORD name and logo are registered marks of ACORD #S243713'I/M2436166 JH02