HomeMy WebLinkAboutARCHITECTURE WEST LLC - INSURANCE CERTIFICATEOP ID: TA
,dacoRO CERTIFICATE OF LIABILITY INSURANCE
01/15/2015
o01/16/M200Z
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 endorsements .
PRODUCER Phone: 970-223-1804
CONTACT
Front Range Insurance Group
1100 Haxton Drive Suite 100 Fax:
Fort Collins, CO 80525
David A. Wooldridge LUTCFAAI
P ONE FAX
X0, arc No:
EJMAIL
PRODUCER
CUSTOM'S I,,.ARCH-34
INSURERS AFFORDING COVERAGE
NAIC#
INSURED Architecture West, LLC.
INSURER A: Secure Insurance Companies
22543
Steve Stelnblcker
INSURERS: PInnacol Assurance
41190
160 Palmer Dr
Ft. Collins, CO 80525
Beasley Insurance Company, Inc
INSURERC:
INSURER D :
INSURER E :
INSURER F :
COVERAGES CFRTIFICATE NIIMRFAI RFVIRIO/d NIIMRFR•
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 WMTH'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 INSURANCEADDL
SUBS
POLICY NUMBER
POLICY EFF
MMIDDIYYYYI
POLICY EXP
(MMIDDIYYYYI
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE �X OCCUR
X
BP3161262
03113/2016
0311312016
EACH OCCURRENCE
S 1,000,08
PREMISES Ea occurrence
$ 100,00
MED EXP (Any one person)
$ 5,00
PERSONAL S ADV INJURY
$ 1,000,00
GENERAL AGGREGATE
$ 2,000,0010
GENL AGGREGATE LIMIT APPLIES PER
POLICY PRO-
JECTLOC
PRODUCTS - COMP/OP AGG
$ 2,000,00
S
A
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNEDAUTOS
-
BP3161262
BP3161262
03113/2015
03/13/2015
03/13/2016
03/1312016
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY (Perperson),
$
BODILY INJURY (Per aWdenp
$
X
PROPERTY DAMAGE
(Peracudent)
$
X
$
$
UMBRELLA LIAR
EXCESS LIAR
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
DEDUCTIBLE
RETENTION $
$
$
B
WORKERS COMPENSATION
YIN
ANY PROPRIETORRARTNERIEXECUTIVE
OFFICERIMEMBER EXCLUDED? IT
(Mandatory In NH)
It yes, desalEe under
DESCRIPTION OF OPERATIONS UeIow
4080892
05101/2015
0510112016
X h;STATU CERH-
T
RLMANDEMPLOYERYLIABILITY
E.L. EACH ACCIDENT
$ 100,00
E, L, DISEASE - EA EMPLOYEE
S 100,00
E.L. DISEASE -POLICY LIMIT
S 500,00
C
Professional Liab
V15ULM140701
0711612014 1
07116/2015
Each Occu 1,000,00
Aggregate 2,000,00
DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, D more span is required)
Holder is listed as athe General
n Additional Insured with regards to
Liability policy.
CITY OF
City of Fort Collins
215 N. Mason Street, 2nd Floor
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.
AUTH
ORIZ
ED REPRESENTATIVE
U 1966-211109 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD