HomeMy WebLinkAbout457580 J F SATO & ASSOCIATES INC - INSURANCE CERTIFICATE (9)Client#: 1084594 JF5
ACORD.. CERTIFICATE OF LIABILITY INSURANCE
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: "a certificate holder is an ADDITIONAL INSURED, the policy(Iss( meat be endorsed. NSUBROGATXIN IS WAIVED, subject to
Me terms and conditions of the policy, certain policies may require an endonemerd. A stelenNM on this eemfkete does not confer rights to tM
certificate holder In lieu of such endomement(s).
USI Colorado, LLC Prof Liab
1515 Wynkoop Street
Suite 200
Denver, CO 80202
J. F. Sato S Associates, Inc.
5878 So. Rapp Street
Littleton, CO 80120
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.
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DESCRIPTION OF OPEMTIONSENnx
E.L. DISEASE - POLICY LIMIT
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DPRO714819
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07/18/201
$1,000,000 per Claim
Liability
$2,000,000 arml aggr•
Claims Made
DESCRIPTON OF OPEIMTIONS I LOCATIONS I VEHICLES(AXwA A001101(I1 Asfftl al Reme,ke eceeduln. Xmon .P.Itt u.d)
As required by written contract or written agreement, the following provisions apply subject to the policy
terms, conditions, limitations and exclusions: The Certificate Holder is Included as Automatic Additional
Insured's for your work, acts or omissions which includes 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 Insureds work performed on behalf of the
(See Attached Descriptions)
City of Fort Collins, Purchasing
PO Box 580
Fort Collins, CO 80522-0000
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2010/05) 1 Df 2 The ACORD name and logo are reglstered marks of ACORD
#S14317940IM14317898 BKSBC
DESCRIPTIONS (Continued from Page 1)
certificate holder and owner. This Insurance policies will apply on a primary and non-contributory basis. A
Blanket Waiver of Subrogation applies for General Liability, Automobile Liability, Umbrella Liability. The
Umbrella I Liability policy provides excess coverage war the General Liability, Automobile Liability and
Employers Liability
Additional Insured: City of Fort Collins
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#514317940IM14317898