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HomeMy WebLinkAbout113275 ALLER-LINGLE-MASSEY ARCHITECTS PC - INSURANCE CERTIFICATE (11)ALLER-3 OP ID: DA CERTIFICATE OF LIABILITY INSURANCE °AT1218/14 "' 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 endorsements . PRODUCER Phone: 970-462-7747 CONTACT Diana VIyII NAME: Brown 8 Brown Inc Fax: 970-484-4165 4532 Boardwalk Dr, Suite 200 Fort Collins, CO 80525 ZONE PNC 970-494-4668 INC No): 9704844165 Ell nAAULE ; dvigil il@bbcolorado.com E. Siwek, CPA INSURERS AFFORDING COVERAGE NAIC N INSURERA:Plnnacol Assurance Company 41190 INSURED Aller-Lingle-Massey Architects INSURER B: Westfield Insurance Company 24112 P.C. 712 Whalers Way, Ste. B-100 INSURERC:Endurance American Specialty 41718 Fort Collins, CO 80525 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 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. INSR LTR OF INSURANCE ADDLTYPE JN SUER POLICY NUMBER POLICY EFF MM/DD/YYYYI POLICY EXP JMM/DDNYYYl LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 B X COMMERCIAL GENERAL LIABILITY CLAIM$ -MADE I -XI OCCUR X BOP0987114 04109114 04I09115 DAMAGE T RENTED PREMISES ERENTE once $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL B ADV INJURY $ 1,000,00 X EBUEPL GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00 Emp Ben. $ 1,000,00 POLICY JECTPRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,00 BODILY INJURY (Per person) $ B X ANY AUTO BOP0987114 04/09/14 04/09/15 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accdent) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,00 AGGREGATE $ 2,000,00 B EXCESS LIAB CLAIMS -MADE BOP0987114 04/09/14 04/09/15 DED I X I RETENTION$ 0 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY A ANY PROPRIETORNARTNER/EXECUTIVE YIN 1951272 04/01114 04/01/16 OFFICER/MEMBER EXCLUDED? NIA X WC STATU- OTH- EL EACH ACCIDENT $ 1,000,00 E. L. DISEASE - FA EMPLOYEE$ 1,000,00 If yes, Eescnbe under DESCRIPTIONOFOPERATIONSbelow E.L. DISEASE - POLICY LIMIT E C Professional DPL10004431601 12/14114 04/01116 Ea Claim 2,000,0010 Liability Aggregate 2,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORO 101, Additional Remark, Schadula, It more apace Is reRum d) The City of Fort Collins is named additional insured with regards to general liability. CITYFT5 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 IJ 1938-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ALLER-3 PAGE 2 NOTEPAD INSDRED'SNAME Aller-Lingle-Massey Architects OP ID: DA DATE 12/08/14 When required by written contract the following applies: Blanket Additional Insured BP 0451 Primary and Non -Contributory BP 1488 Blanket Waiver of Subrogation BP 0496 Additional Insured - State or Governmental Agency or Subdivision or Political Subdivision - Permits or Authorization Relating to Premises BP 0407 Blanket Additional Insured - Owners. Lessees or Contractors with lAdd Insured Requirements for Parties in Construction Conttact - BP 1487 is - Additional Insured CA 0778 Waiver of Subrogation CA 0444 - Following Form Compensation - Blanket Waiver of Subrogation 359-B ALLER-3 OP ID: DA ,Akka o CERTIFICATE OF LIABILITY INSURANCE Dar1Ral wrrrr) 12/08/08/14 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 endorsements . PRODUCER Phone: 970482-7747 CONTACT NAME: Diana Vlgll Brown &Brown Inc Fax: 97O-484-4165 4532 Boardwalk Dr, Suite 200 Fort Collins, CO 80525 Kilren E. Siwek, CPA PHONE 9704944668 FAX ac No J: aC No): 9704844165 A DRIEss: dvigil@bbcolorado.com INSURERS AFFORDING COVERAGE NAIC p INSURERA: Pinnacol Assurance Company 41190 INSURED Aller-Lingle-Massey Architects P.C. 712 Whalers Way, Ste. B-100 INSURER B: Westfield Insurance Company 24112 INSURER C: Endurance American Specialty 41718 INSURER D: Fort Collins, CO 80525 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 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. INSR LTR TYPE OF INSURANCE OOL BR I POLICY NUMBER POUCY EFF fMM1DD1YYYY1 POLICY EXP (MMIDDNYYY)UNITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FXI OCCUR X BOP0987114 04/09/14 04109115 DAMAGI RENTED PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL B ADV INJURY $ 1,000,00 X EBL/EPL GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG IS 2,000,00 POLICY PRO- "ITLOC Emp Ben. $ 1,000,00 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident E 1,000,00 BODILY INJURY (Per person) $ B BOP0987114 04/09114 04109/16 ALL OWNED SCHEDULED AUTOS AUTOS JANYAUTO BODILY INJURY (Peramtlem ) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ $ X UMBRELLALBIB X OCCUR EACH OCCURRENCE $ 2,000,00 AGGREGATE $ 2,000,00 B EXCESS LIAB CLAIMS -MADE BOP0987114 04/09/14 04/09/15 DED X RETENTION$ 0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN OFFICER/MEMBER EXCLUDED? N/A 1951272 04101114 04/01115 WC STATU- OTH. X I IIT EL EACH ACCIDENT E 1,000,00 E. L. DISEASE - EA EMPLOYEE $ 1,000,00 (Mandatory In NH) _ If yes, tlas 0be under DESCRIPTION OF OPERATIONS below _7 E. L. DISEASE -POLICY LIMIT $ - 1,000,00 C Professional DPL10OD4431601 12114114 04/01/16 Ea Claim 2,000,00 Liability Aggregate 2,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) South Transit Center. The City of Fort Collins is named as an additional insured with regards to general liability. CITYFC2 City of Fort Collins 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 REPRESENTATNE ©1988.2010 ACORD CORPORATION. All rinhtn rasamod ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD No Text ALLER-3 OP ID: DA CERTIFICATE OF LIABILITY INSURANCE DAT12/08DIYYYY) F 12/osna 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 endorsements . PRODUCER Phone: 970482-7747 CONTACT Diana Vigil Brown 8 Brown Inc Fax: 970-484-4165 4532 Boardwalk Dr, Suite 200 PHONE g70-494-4668 FAX AIC No Ext No: 970484-4165 Fort Collins, CO 80525 Karen E. Siwek, CPA aooRess: civigil bbcolorado.com INSURER AFFORDING COVERAGE NAIC N INSURER A: Pinnacol Assurance Company 41190 INSURED Aller-Lingle-Massey Architects INSURER B: Westfield Insurance Company 24112 P.C. 712 Whalers Way, Ste. B-100 INSURER C: Endurance American Specialty 41718 Fort Collins, CO 80525 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 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. INSR LIP TYPE OF INSURANCE ADDL UBR POLICY NUMBER POLICY EFF MMIDDIYYYY) POLICY EXP (MMIDDIYYYYI LIMITS GENERAL LABILITY EACH OCCURRENCE $ 1,000,00 B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X BOP0987114 04/09/14 D4109115 PREMMISEND RENTED PREES Ea occurrence $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL B ADV INJURY $ 1,000,00 X EBL/EPL GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00 POLICY 7 PRO LOC Emp Ben. $ 1,000,00 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea awdent $ 1,000,00 BODILY INJURY (Per person) $ B X ANY AUTO X BOP0987114 04/09/14 04/09/15 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per awdent) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ E X UMBRELLA LUIB X OCCUR EACH OCCURRENCE $ 2,000,00 AGGREGATE $ 2,000,00 B EXCESS LIAB CLAIMS -MADE BOP0987114 04/09/14 04/09115 DED X RETENTION $ 0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory In NH) NIA 1951272 04/01/14 04/01/15 X I WC STATU- OTH- t E.L. EACH ACCIDENT 8 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000r00 It yes, desalbe under DESCRIPTION OF OPERATIONS below EL.DISEASE -POLICY LIMIT 1 $ 1,000,00 C Professional DPLID004431601 12114/14 04101/16 Ea Claim 2,000,00 Liability Aggregate 2,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace Is rayulred) City of Fort Collins and Wattle and Daub Contractors are Additional Insured with respect to General Liability and Automobile Liability. Project: 7666 Bobcat Ridge Historic Buildings Rehabilitation CITYFC2 City of Fort Collins 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. AUTHORRED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD No Text