HomeMy WebLinkAboutTHE BAUEN CORPORATION - INSURANCE CERTIFICATE (5)ACORD. CERTIFICATE OF LIABILITY INSURANCE
5/1/2015
DATE(MM/DD/YYYY)
1 9/19/2014
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(les) 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 Lockton Companies
8110 E Union Avenue
Suite 700
Denver CO 80237
(303) 414-6000
CONTACT
AM
Nhi
FAX
A/C No Ext : A/C No);
E-MAIL
ADD
INSUREINSURERISI AFFORDINGNAIL
INSURER A: ValleV Fore Insurance Compariv
20508
INSURED The Bauen Corporation
1034102 801 E.52ndAve.
Denver, CO 80216
INSURER B: Continental Casualty Compairy
20443
INSURERC: Pinnacol Assurance Company
41190
I.N The Continental Insurance Cam an
35289
COVERAGES BAUC003 CERTIFICATE NUMBER: 1991907 REVISION NUMBER: XXXXXXX
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.
INSRR
TYPE OF INSURANCE
ADDL
INSD
SUER
VIVID
POLICY NUMBER
MMIDDI EFF
POLICY EXP
LIMITS
A
X
COMMERCIAL GENERAL LABILITY
CLAIMSAIADE a OCCUR
N
N
4021109791
5/1/2014
5/1/2015
EACH
OCCURRENCE
1000000
DAMAGE
PREMISE
TO RENTED
o¢unence
100,000
MED EXP (Any oneperson)
5,000
PERSONAL a ADV INJURY
S 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICYrX JEt° ❑LOC
OTHER
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS- COMPIOP AGG$2000000
It
D
AUTOMOBILE
LABILITY
ANY pAUTO
ALTOS NED SCHEDULED
HIRED AUTOS X NON -OWNED
N
N
402110598
5/1/2014
5/1/2015
COMBINEeDSINGLE LIMIT
$ 1,000,000
X
BODILY INJURY (Per Person)
$ XXXXXXX
BODILY INJURY (Per accident
s XXXXXXX
X
PROPERTY
accident) DAMAGE
s XXXXXXX
$XXXXXXX
B
)(
UMBRELLA LAB
EXCESS LIAB
X
OCCUR
CIAIMS-MADE
N
N
4021109807
5/1/2014
5/1/2015
EACH OCCURRENCE
s5000000
AGGREGATE
s 5,000,000
DED I I RETENTION $
s XXXXXXX
C
WORKERS COMPENSATION
AND EMPLOYER$ LABILITY i YIN
ANY PROPRIETORPARTNERIE%ECUTNE ❑
R/ OFFICEMEMBER EXCLUDED? N
IIyMnMory In NH)
mdeferniturder
DESCRIPTION OF OPERATIONS feel.
N / A
N
2127630
10/1/2014
10/1/2015
PER OTH
X STATUTE
El EACH ACCIDENT
s 1 000 000
EL DISEASE - EA EMPLOYEE
1000000
EL DISEASE -POLICY LIMIT
1 1000000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule. may M attached if mart space is rtquin d)
GtH I IFIUA I t HULUtH t:ANGtLLA I IUN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
1991907 AUTHORIZED REPRESENTATIVE
City of Fort Collins
P.O. Box 580
Fort Collins CO 80522 J I
ACORD 25 (2014101) 01 8 014 ACORD CORP09ATION. All rights reserved
The Acnwn ...,..e Ana loon of ar.nRn