HomeMy WebLinkAbout103885 COMPUTER SITES INC - INSURANCE CERTIFICATE (4)COMPSIT-01 NADARTS
'A`� �� CERTIFICATE OF LIABILITY INSURANCE
°AT8/4� 014 n
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
Willis of Colorado, Inc.
c%o26CenturyBlvtl
P.O. Box 305191
Nashville, TN 37230-5191
CONTACT
NAME: certificates@willis.com
PHONE FIX
acNeExt:(877)945-7378 JCNo:(888)467-2378
EMAIL
ADDRESS:
INSURERS AFFORDING COVERAGE
NAIC M
INSURER A: Continental Insurance Company
35289
INSURED
INSURER B: Valley Forge Insurance Company
20508
Computer Sites, Inc.
1225 South Huron
INSURER C: Continental Casualty Company
20443
INSURER D: Pinnacol Assurance Company
41190
Denver, CO 80223
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.
INSRLTR
LTR
TYPE OF INSURANCE
AnmPOLICY
NUMBER
MMIIDCDNYYYY Y EFF
MM/D�NYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE X❑ OCCUR
4024840653
8/1/2014
8/1/2015
EACH OCCURRENCE
$ 1,000,00
PREMISES Ea occurrence
$ 1,500,00
MED EXP (Any one Person)
$ 5,00
PERSONAL 6 ADV INJURY
$ 1,000,00
GEN'L
AGGREGATE LIMIT APPLIES PER:
POLICY JERCT LOC
OTHER:
GENERALAGGREGATE
$ 2,000,00
PRODUCTS - COMP/OP AGG
$ 2,000,00
$
B
AUTOMOBILE LIABILITY
X ANY AUTO
AUTOSS AUTOS OSCHEDULED
AU
NON -OWNED
HIRED AUTOS AUTOS
4024840636
8/1/2014
B/1/2015
COMBINED SINGLE LIMIT
Ea a.,d.nt
$ 1,000,00
BODILY INJURY (Per person)
$
BODILY INJURY (Per oxidant)
$
PROPERTY DAMAGE
Per eramidaxident
$
C
X
UMBRELLA LIAR
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
CUP4030406096
8/1/2014
8/1/2015
EACH OCCURRENCE
$ 10,000,00
AGGREGATE
$ 10,000,00
DED I X I RETENTION$ 10,000
$
D
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOWPARTNER/EXECUTIVE Y/N
OFFICERMIEMBER EXCLUDED?
(Mandatory in NH)
It a, descnbe under
DESCRIPTION OF OPERATIONS below
N/A
4107093
8/1/2014
8/1/2015
X PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$ 1,000,00
E.L. DISEASE - EA EMPLOYE
$ 1,000,00
E.L. DISEASE - POLICY LIMIT
$ 1,000,00
DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (ACORD 101, Additional Remark, Schedule, may be attached If mom space Is required)
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
City of For Collins, Colorado
P.O. Box 580
01988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD