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HomeMy WebLinkAbout455706 STOLFUS & ASSOCIATES INC - INSURANCE CERTIFICATE (8)Client#: 1087135 STOLFASS ACORD. CERTIFICATE OF LIABILITY INSURANCE DADO/YYYY) s/2n9/2s/zola 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 endomement(s). PRODUCER CONTANAME: Nancy Roman USI Colorado, LLC Prof Liab ° No 800 873-8500 1515 Wynkoop Street ucEM: ac Np: n411AILDDREs: Nancy.Roman@usi.biz Suite 200 Denver, CO 80202 INSURERIS) AFFORDING COVERAGE NAIL p INSURER A: Hartford Casualty Insurance Com 29424 INSURED B: Hartford Fire Ins Co of the Mid 19682 StolfINSURER us & Associates, Inc. INSURER C:XL Specialty Insurance Company 37885 690 5690DTC Boulevard INSURER D: ' .Suite 101W NSER URE: Englewood, CO 60111 INSURER F: CUvtHAUts 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 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. DISK TYPE OF INSURANCE AODL'SUB INSR WVO POLICY NUMBER POLICY EFF MWDD POLICY EXP MM/DD/Y1-YY OMITS A GENERALLIABILITY Y Y 34SBWPD4904 10101/201410/01/201 EACHOCCURRENCE$1000000 X COMMERCIALGENERM-UABILITY CLAIMS -MADE a OCCUR PREMISE$ EaEcoanrence $11 OOO1 OOO MED EXP (Any one person) $10 000 PERSONAL S ADV INJURY $1,000000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $2,000,000 POLICY X jE 0- LOC I $ A AUTOMOBILE LIABILITY Y Y 34SBWPD4904 10/011201410101/201 EaacrideOtsINGLEDMIT 1,000,000 BODILY INJURY( Per Person) $ AUTO ALL OS SCHEDULED AUTOS AUTOS HIRED AUTOS X NON-0WNED AUTOS IXANY BODILY INJURY Per acudent ( ) $ PROPERTY DAMAGE Per awdent $ A �( UMBRELLALIAB X OCCUR Y Y 34SBWPD4904 10/Q11201410101/201 EACHOCCURRENCE $1000000 AGGREGATE $1000000 EXCESS LUi CLAIMS -MADE DED I X RETENTION$10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � N/A Y 34WEGBS5226 10/01/201410/01/201 WC STA X TU- oTH- E.L. EACH ACCIDENT 11,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory In NH) If yes, describe under EL.DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below C Professional N Y DPR9718312 10/01/2014 10/01/201 $1,000,000 per claim Liability $2,000,000 annl aggr. Claims Made DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, N 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 Financial Services PO Box 580 Purchasing Division 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 ©1988-2010 ACORD CORPORATION. All rights reserved. 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 I Excess Liability policy provides excess coverage over the General Liability, Automobile Liability and Employers Liability. Additional Insured: City of Fort Collins SAGITTA 25.3 (2010105) 2 of 2 #5133874281M13387075