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HomeMy WebLinkAbout121438 BHA DESIGN - INSURANCE CERTIFICATEBHADE-1 OP ID A`COfRO CERTIFICATE OF LIABILITY INSURANCE F ATE(MM/DD/YYYY) 04( 2/2019 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 Brown & Brown Inc 4532 Boardwalk Dr, Suite 200 Fort Collins, CO 80525 House Account INSURED BHA Design Inc 1603 Oakrldge Drive, Suite 100 Ft Collins, CO 80525 INSURER F : Hartford Fire Insurance Co. Pinnacol Assurance Company COVERAGES CERTIFICATE NUMBER: REVISION NUMBER' 165 19682 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 TYPE OF INSURANCE DDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Business Owners Y ,34SBAPQ9520 04/01/2019 04/01/2020 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED PREMISESjEa occwner MED EXP (Any oneperson) $ _ 300,600 $ 10,000 X GEN'L PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY PRO- ❑ LOC JECT OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG 2,000,000 $ AUTOMOBILE X LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT accident) ccid nt $ BODILY INJURY Perperson) $ BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 34SBAPQ9520 04/01/2019 04/01/2020 EACH OCCURRENCE 4,000,000 AGGREGATE 4,000,000 DED X RETENTION $ 10000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) - If es, describe under DESCRIPTION OF OPERATIONS below N / A 3202793 04/01/2019 04/01/2020 PER OTH- AT T E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 PROPERTY 275,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) contract. form SS0008 4-05 CITFORT City of Fort Collins Purchasing Department P.O. Box 280 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 House Account ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD