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HomeMy WebLinkAbout343965 IN-SITU INC - INSURANCE CERTIFICATE (2)ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 09117/2018 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 have ADDITIONAL INSURED provisions or 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 Flood and Peterson PO Box 578 Greeley CO 80632 CONTACT NAME: Kimberly Stephens, CIC a/c° No Ell: (970) 356-0123 AC No): (970) 330-1867 E-MAIL ADDRESS: KStephens@floodpeterson.com INSURER(S) AFFORDING COVERAGE NAIC 11 INSURER A : Atlantic Specialty Insurance Company 27154 INSURED In -Situ, Inc. 221 E Lincoln Ave Fort Collins CO 80524 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : nn%1=PAca¢ CFRTIFIt^-ATF NI IMRFR• CL1891125146 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. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDNYYY MM/DDNYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR PREMISES Ea occurrence $ 500,000 MED EXP (Any one person) $ 10,000 PERSONAL a ADV INJURY $ 1,000,000 A 711012769 09/01/2018 09/01/2019 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY ❑ JECT PRO ❑ LOC Employee Benefits $ 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ A OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 711012769 09/01/2018 09/01/2019 PROPERTY DAMAGE Per a.d.nt $ X UMBRELLA LIAR I X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE 711012769 09/01/2018 09/01/2019 AGGREGATE $ 5,000,000 DED I X1 RETENTION $ 0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE � OFFICER/MEMBER EXCLUDED, (Mandatory In NH) NIA 406041127 09/01/2018 09/01/2019 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 1, 000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ i,000,000 If yes, descnbe under DESCRIPTION OF OPERATIONS below Each Claim Limit $2,000,000 A Professional Liability 711012769 09l01/2018 09/01/2019 Annual Aggregate $2,000,000 Deductible Per Claim $25,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) C EI ED SEP 2 0 2018 City Manager's Office 1111=0 ICUATo unf ncD i^_ANCFI I ATInN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. 300 Laporte Ave AUTHORIZED REPRESENTATIVE Fort Collins CO 80526 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD