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Home My WebLink About501351 WORKSPACE INNOVATIONS LTD - INSURANCE CERTIFICATE (2)`'� a CERTIFICATE OF LIABILITY INSURANCE 8/29/2014w' 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 Moody Insurance Agency, Inc. 8055 East Tufts Avenue Suite 1000' - Denver CO 80237 CONTACT CathyBaker NAME: FAX Not: EMAIL .cathy.baker®moodyins.com ik-,E.-mc;thy.baker@moodyins.com INSURERS AFFORDING COVERAGE NAICS INSURERA:Union Insurance Co 25844 INSURED Workspace Innovations, LLC 4414 E. Harmony Road #100 Port Collins CO 80526 INSURER B:Pinnacol Assurance 41190 INSURERC: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:14-15 w/forms 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. INSA LTR TYPE OF INSURANCE R POLICY NUMBER POLICY EFF MMMD/YYYY POLICY EXP MMMDNYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X CPA307033424 /1/2014 /1/2015 EACH OCCURRENCE E 11000,000 PREMISES Ea occurr0ence 3 300,000 MED EXP (My one Person) $ 10,000 PERSONAL &ADV INJURY 3 11000,000 GENERAL AGGREGATE E 2,000,000 GEN'L AGGREGATE X POLICY LIMIT APPLIES PER: PRO LOO PRODUCTS - COMP/OP AGG E 2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS NOON -OWNED HIRED AUTOS N . CPA307033424 9/1/2014 9/1/2015 EOaBINEDcid tSINGLE LIMIT 11000,000 X BODILY INJURY (Per person) E BODILY INJURY (Per amident) E X PROPERTY DAMAGEAUTOS (Per awident) E - S A X UMBRELLA LIAB EXCESS LIAB OCCUR GLAIMSMADE /1/2014 /1/2015 EACH OCCURRENCE S 4,000,000 AGGREGATE 3 4,000,000 DED I I RETENTIONS 3 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YINI ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED' (Mandatory in NH) It yes, describe under DESC RIPTION OF OPERATIONS below N/A 129130 /1/2014 /1/2015 WC $TATU- OTH- TOR E.L. EACH ACCIDENT $ 1,000 000 E. L. DISEASE - EA EMPLOYE E 1,000 000 E. L. DISEASE -POLICY LIMIT E 1 000 D00 DESCRIPTION OF OPERATIONS / LOCATIONS VEHICLES (Attach ACORD 101, Additional Remarks Schedub, R more space is required) City of Fort Collins included as an Additional Insured with respect to General Liability as required by written contract. City of Fort Collins Attn: Jennifer Harvey 215 N. Mason St Fort Collins, CO 80522 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) Baker/CATBAR O 1988-2010 ACORD CORPORATION. All rinhts reserved_ INS025 (201005)�01 The ACORD name and logo are registered marks of ACORD