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Home My WebLink About439706 BELFORD WATKINS GROUP LLC - INSURANCE CERTIFICATEClient#: 1083601 BELFOWAT ACORD,, CERTIFICATE OF LIABILITY INSURANCE DATE IMM Do3127/2i 015 1'5YYY) /27/2 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 P.O. Box 7050 Englewood, CO 80155 800 873-8500 CT NIipME: aC N, Est): 800 873-6500INC. No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Sentinel Insurance Company Ltd. 11000 INSURED INSURERS: XL Specialty Insurance Company 37885 Belford Watkins Group, LLC PO Box 1306 INSURER C Fort Collins, CO 80522 INSURER D INSURER E INSURER F : CnVFR AGFA CERTIFICATE NUMRFR: 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. TYPE OF INSURANCE ADDIN INSR V yD POLICY NUMBER YSFI WDD EFF NY/DDMM/1 P LIMITS A GENERAL LIABILITY Y Y 34SBAPM7802 7/08/2014 07/08/2015 EACH $1 000000 X COMMERCIAL GENERAL LIABILITY p PREMEaE�r Mote $1 000 000 CLAIMSMADE O OCCUR MED EXP (Any one Person) $10 000 PERSONAL 8 ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $2 000,000 POLICY X PRO-ECT 7 LOC $ A AUTOMOBILE LIABILITY Y Y 34SBAPM7802 7/08/2014 07/08/201 ( °Mae1IId8D151NGLE LIMB 1 ow wo BODILY INJURY (Per person) ANY AUTO $ ALL OWNED SCHEDULED AUTOS AUTOS f IXHIRED AUTOS X AUTOS BODILY INJURY (Per accident) $ $ _. (Par=IDAMAGE I (Par E A UMBRELLA LIAR X OCCUR Y Y 34SBAP111117802 7/08/2014 07/08/2015 EACH OCCURRENCE $1 000 000 _ AGGREGATE EXCESS LIAR CLAIMS -MADE $1,000,000 DIED I X RETENTION $1O 000 $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? 71 MIA E.L EACH ACCIDENT $ -- (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMB $ $1,000,000 per claim B Professional N Y _ _ _ DPS9723M 3/15/2015 03115/2016 Liability $1,000,000 annl aggr. Claims Made DESCRIPTION OF OPERATIONS / LOCATIONS / 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 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) r1ULU=M City of Fort Collins 215 N Mason 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 (2010/05) 1 of 2 #S14731032/M14728852 01988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHDZP 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 and Umbrella/Excess Liability. The Umbrella / Excess Liability policy provides excess coverage over the General Liability and Automobile Liability. Additional Insured: City of Fort Collins SAGITTA 25.3 (2010/05) 2 of 2 #S14731032/M14728852