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HomeMy WebLinkAbout330179 INTERWEST CONSULTING GROUP - INSURANCE CERTIFICATE (18)Client#: 1086878 INTERCON35 ACORD.CERTIFICATE OF LIABILITY INSURANCE DATE 11/01/os/z612ol0/Y4 a 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 USI Colorado, LLC Prof Liab 1515 Wynkoop Street Suite 200 Denver, CO 80202 CONTACT NAME: PHONE 800 873.8500 FAX AIL, No, Et :INC, No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NNC# INSURER A: Travelers Insurance Company 19038 INSURED INSURER B: XL Specialty Insurance Company 37885 Interwest Consulting Group P.O. Box 18330 'INSURER C: Boulder, CO 80308 INSURER D : 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 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. LTRR TYPE OF INSURANCE NSR SUBR MD POLICY NUMBER MMIDOY� MMIUUYIYYNY LIMIT$ A GENERAL LIABILITY X X 680746OM671 11/14/201411/14/201S EACH OCCURRENCE $2,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR PREMISES TORENTED$1,000,000 MED EXP (Any one person) $10,000 PERSONAL B ADV INJURY s2,000,000 GENERAL AGGREGATE $4,000,000 GEN'L AGGREGATE LIMITJC, APPLIES PER: PRODUCTS AGG $4,000,000 POLICY X PRO- LOG $ A AUTOMOBILE LIABILITY X X BA7466M429 11/14/2014 11/1412015 COMBINED SINGLE LIMIT Ea accident 1,000,OQO X BODILY INJURY (Par person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per amdent) $ X PROPERTY DAMAGE Per amident $ HIRED AUTOS X NON -OWNED AUTOS A X UMBRELLA LAB X OCCUR X X CUP4175T615 11/14/2014 11/1412015 EACHOCCURRENCE $1,000,000 AGGREGATE $1000000 EXCESS LAB CLAIMS -MADE DED I X RETENTION SO $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVEYIN OFFICERIMEMBER EXCLUDED? N] NIA X XVMPJUB1339T ' 11/14/2Q 1411114/201 OTH- X WCSTATU- DR EL EACH ACCIDENT $1000000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 B Professional Liab DPR9718608 11/14/2014 11/14/201 $1,000,000 per claim Pollution Liab $5,000,000 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 and owner are included as Automatic Additional Insured's for ongoing and 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 Insured's work performed on behalf of the certificate holder and owner. (See Attached Descriptions) City of Fort Collins, Purchasing P.O. 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 ACORD 25 (2010/05) 1 of 2 #S13699130/M13690189 V,41s ©1988.2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD LXOBC Client#: 1086878 INTERCON35 ACORD. CERTIFICATE OF LIABILITY INSURANCE D11/062014 11/os/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(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: USI Colorado, LLC Prof Liab PHHCH o Eat,: g00 873-8500 FAX ac, Na: 1515 Wynkoop Street EMAIL Slate 200 ADDRESS: Denver, CO 80202 INSURER(S) AFFORDING COVERAGE NAIC e INSURER A: Travelers Insurance Company 19038 INSURED INSURER B: XL Specialty Insurance Company 37885 Interwest Consulting Group P.O. Box 18330 INSURERC: Boulder, CO 80308 INSURERD: INSURER E NSURER 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 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 rypE OF INSURANCE ADDLSUSR INSR WVD POLICYNUMBER POLICY EFF MMIDDIYYYY POLICY UP MM/DDNNYN' LIMITS A GENERAL LMBIUTY X X 6807444M622 11/14/2014 11/14/201 EEAACHOCTCURRENCE $2,000 000 X COMMERCIAL GENERAL LIABILITY PREMISES EaEoNccunence $1,000,000 CLAIMS -MADE ❑OCCUR MED EXP (Any one person) $10000 PERSONAL B AOV INJURY $2,000,000 GENERAL AGGREGATE $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $4,000,000 POLICY X PRO-'ECT El LOC $ A AUTOMOBILE LIABILITY X X BA74661111429 11/14/2014 11/14/201 cEa arde...deOSInt NGLE LIMIT 1,000,000 BODILY INJURY(Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS OS AUT P (eracen)BODILY INJURY Pdtlt $ HIRED AUTOS X NONOWNED AUTOS PROPERTY DAMAGE Per accident $ A X UMBRELLA DAB X OCCUR X X CUP4175T615 11/14/2014 11/14/2015 EACH OCCURRENCE s1 DDD DDD AGGREGATE $1 DDD DDD EXCESS LIAR CLAIMS -MADE DED X RETENTION$0 $ A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOWPARTNEWEXECUTIVEYIN OFFICER/MEMBER EXCLUDED? � NIA X X XVMPJUB1339T UB1341TO51 11114/201411/14/201 11/14/201411/14/201 X WCSrAMIj OTH- E.L. EACH ACCIDENT $1000000 E.L. DISEASE -EA EMPLOYEE $1,000000 (Mandatory In NH) If yes, desrnbe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 B Professional Liab DPR9718608 /2014 11/14/2015 $1,000,000 per claim Pollution Liab r $5,000,000 Brunt aggr. Claims Made DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD tet, Additional Remarks Schedule, If more apace 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 Insured under Umbrella / Excess Liability but only with respect to liability arising out of the Named Insured's work performed on behalf of the certificate holder and owner. (See Attached Descriptions) City of Fort Collins Purchasing Division PO BOX 580 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 (2010I05) 1 Of 2 The ACORD name and logo are registered marks of ACORD #S13698644/M13690086 LXOBC DESCRIPTIONS (Continued from Page 1) 1 The General Liability, Automobile Liability, Umbrella/Excess insurance policies applies on a primary and noncontributory basis. A Blanket Waiver of Subrogation applies for General Liability, Automobile Liability, Umbrella/Excess Liability and Workers Compensation. The Umbrella / Excess Liability policy provides excess coverage over the General Liability, Automobile Liability and Employers Liability. RE: Renewal, 7392 Civil Enginering Design, Drafting & Survey Services On Call Additional Insured: City of Fort Collins SAGITTA 25.3 (2010105) 2 of 2 #S13698644/M13690086