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Home My WebLink About457580 J F SATO & ASSOCIATES INC - INSURANCE CERTIFICATE (7)Client#: 1084594 JF5 ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YyYY) 06/19/2014 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 NAME:C US] Colorado, LLProf Liab PHONE 800 873-8500 FAX 1515 Wynkoop Street AIC No Eat : E-MAIL Suite 200 ADDRESS: Denver, CO 80202 INSURER(S) AFFORDING COVERAGE NAIC If INSURER A: Hartford Casualty Insurance co 29424 INSURED INSURER B: XL Specialty Insurance Company 37885 J. F. Sato &Associates, Inc. 5878 So. Rapp Street INSURER C: Littleton, CO 80120 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: PPVLCInM Mnminco- 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 CONTRACTOR 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 TYPE OF INSURANCE ADDL INSft SUB VND POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY X X 34SBWPP2160 1/31/2014 01131/201 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMSMADE OCCUR PREMISES EaEo vE,.ace $300 000 MED EXP(Anyone pars.) $10000 PERSONAL S ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $2,000,000 POLICY X jEa LOG I A AUTOMOBILE LIABILITY X X 34SBWPP2160 COMBINEDSINGLELIMITEa eccitla 1,000,000 BODILY INJURY(Per person) $ALL ANY AUTO OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $XHIRED AUTOS XNON-OWNEDPROPERTY DAMAGEAUTOS Per amount $A X UMBRELLA LIAR X OCCUR X X 34SBWPP2160 EACH OCCURRENCE $$00O 00Q AGGREGATE g$ QQOQQQDED EXCESS LIAR CLAIMS -MADE X RETENTION$10000$WORKERS 307/18/201$1,000,000 COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ N/A(Mandatory WC STATLL OTH- PIZ E.L. EACH ACCIDENT S E.L. DISEASE -EA EMPLOYEE EDESC In NH)If yes, IPTI Nei antler OF OPERATIONS OalowB E.L. DISEASE -POLICY LIMIT $DESCRIPTION Professional DPR9714819$1,000,000 per claim Liability $2,000,000 annl aggr. Claims Made DESCRIPTION OF OPERATIONS I LOCATIONS I 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 is included as Automatic Additional Insured's for your work, acts or omissions which includes 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 Insureds work (See Attached Descriptions) City of Fort Collins, Purchasing PO Box 580 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 114 V ACORD 25 (2010105) 1 of 2 #S12724007/Mi2723943 L9'IBBB-2U10 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD LXOBC DESCRIPTIONS (Continued from Page 1) performed on behalf of the certificate holder and owner. This insurance policies will apply on a primary and non-contributory basis. A Blanket Waiver of Subrogation applies for General Liability, Automobile Liability, Umbrella Liability. The Umbrella / Liability policy provides excess coverage over the General Liability, Automobile Liability and Employers Liability Additional Insured: City of Fort Collins SAGITTA 25.3 (2010/05) 2 of 2 #S12724007/M12723943