HomeMy WebLinkAbout101882 VAUGHT FRYE LARSON ARCHITECTS - INSURANCE CERTIFICATE (3)Client#: 1085325
VAUGHFRY
ACORD,. CERTIFICATE OF LIABILITY INSURANCE
DATE
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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
Nancy Roman
USI Colorado, LLC Prof Liab
PHONE 800 873-8500 FAX
A/C No Eat): A/C, No:
1515 Wynkoop Street
E-MAIL -ADDRESS, Nancy.Roman@usi.biz
Suite 200
Denver, CO 80202
INSURERS) AFFORDING COVERAGE
NAIC #
INSURER A: XL Specialty Insurance Company
37885
INSURED
INSURER B: Hartford Fire Insurance Co
19682
Vaught Frye Larson Architects (VFLA)
INSURER C : Hartford Underwriters Ins Co
30104
401 West Mountain Ave., Suite 100
INSURER 0: Hartford Insurance Co Midwest
37478
Fort Collins, CO 80521
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.
INSR
LTR
rypE OF INSURANCE
ADDLSUB
INSR
WVD
POLICY NUMBER
POLICY EFF
MMIDD
POLICY EXP
MWDD/YYYY
LIMITS
B
GENERAL LIABILITY
34SBWVT6123
7/01/2014
07101/201E
EACH OCCURRENCE
$1000000
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE F7x OCCUR
RAMAGET RENTED
REMISES Ea occunence
$ 300 000
MED EXP (Any one person)
$10 000
PERSONAL B ADV INJURY
$1,000,000
GENERAL AGGREGATE
$2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMP/OP AGG
$2,000,000
POUCY X PRa LOC
$
C
AUTOMOBILE
LIABILITY
34UECP08278
7/01/2014
07/01/201
COMBINEDSINGLE LIMIT
O aBINEDt
1,000,000
X
BODILY INJURY (Per person)
$
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
HIRED AUTOS X NON -OWNED
AUTOS
BODILY INJURY (Peraccident)
( )
$
X
PROPERTY DAMAGE
Per accitlant
$
B
X
UMBRELLA LIAB
X
OCCUR
34SBWVT6123
7/01/2014
07/01/201
EACH OCCURRENCE
$1000000
AGGREGATE
$1 00O 00O
EXCESS LIAB
CLAIMS -MADE
DED I X RETENTION$10000
$
D
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? IN]
N / A
34WEGKC6664
7/01/2014
07/01/201
X WCSTATu- OTH-
TMIS
E.L. EACH ACCIDENT
$1 000000
E.L. DISEASE - EA EMPLOYEE
$1 000 000
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE -POLICY LIMIT
$1,000,000
A
Professional
DPR9714723
1710112014
0710112011
$2,000,000 per claim
Liability
$2,000,000 annl aggr.
Claims Made
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach 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 Automatic
Additional Insured's for ongoing and completed operations under General Liability; Designated Insured under
Automobile Liability; and Additional Insureds under Umbrella / Excess Liability but only with respect to
liability arising out of the Named Insured work performed on behalf of the certificate holder and owner.
(See Attached Descriptions)
City of Fort Collins Attn:
Purchasing
215 North Mason Street
Fort Collins, CO 80522-0000
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 2
$C17r.A41A7/M19AA97n7
U 1983-2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
MAIL
DESCRIPTIONS (Continued from Page 1)
The General Liability, Automobile Liability, Umbrella/Excess insurance applies on a primary and non
contributory basis. A Blanket Waiver of Subrogation applies for General Liability, Automobile Liability,
Umbrella/Excess Liability and Workers Compensation. The Umbrella / Excess Liability policy provides excess
coverage over the General Liability, Automobile Liability and Employers Liability.
Additional Insured: City of Ft. Collins
SAGITTA 25.3 (2010/05) 2 of 2
#S12663367/M12662707