HomeMy WebLinkAbout611149 ENGINUITY ENGINEERING SOLUTIONS INC - INSURANCE CERTIFICATEACl ® DATE(MM/DD/YYYY)
--- CERTIFICATE OF LIABILITY INSURANCE 05/10/19
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 NAME: MARK R. BEASLEY
BENCHMARK INSURANCE AGENCY LLC PHONE 303 730-2852 FAx
66 W Springer Dr #215 EMAIL EXt: Ac No:(303) 730-2910
ADDRESSbenchmarkinsurance90@ ahoo.com
Highlands Ranch, CO 80129 INSURER(S) AFFORDING COVERAGE I NAILS
INSURED Enginuity Engineering Solutions, Inc
10106 W San Juan Way, Suite 215
Littleton, CO 80127
(720)306-8222
INSURER A: Ohio Casualty Insurance Company
INSURER B :
inlcl IF7FG c . LLOYDS OF LONDON
INSURER D :
INSURER E
rnvCRA(]CQ rGRTIGInATF Kit IAARFLT- RFVIRInN Ni IMRFR•
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
VTR
TYPE OF INSURANCEAD
R
WVD
POLICY NUMBER
P LI Y EFF
MM/DD/
POLI Y EXP
MM/DD
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 2,000, 000
PREMISES Ea occurrence
$ 2 000 000
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE FRI OCCUR
MED EXP (Any one person)
$ 15 000
PERSONAL & ADV INJURY
$ 2, 000, 000
A
BZS 16-55143751
07/03/2019
07/03/2020
X
GENERAL AGGREGATE
$ 4,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 4, 000, 000
X POLICY jpERCOT LOC
AUTOMOBILE LIABILITY
Ea accident
$ 2, 000, 000
BODILY INJURY (Per person)
$
A
ANYAUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
X HIRED AUTOS N AUTOS
)[
BZS 16-55143751
07/03/2019
07/03/2020
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
A
X
UMBRELLA LIAB
EXCESS LIAB
I
OCCUR
CLAIMS -MADE
USO 16-55143751
07/03/2019
07/03/2020
EACH OCCURRENCE
$ 5,000,000
X
AGGREGATE
$
DED I X I RETENTION $ 10 000
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y/N
ANY PROPRIETORIPARTNER/EXECUTIVE El
OFFICER/MEMBER EXCLUDED?
(Mandatory In NN)
N/A
NIA
X WCSTATU- OTH-
TORYLIMITS ER
EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
:$
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$
EACH CLAIM 2,000,000
C
PROFESSIONAL E&O
ANE1486206. 18
09/10/2018
09/10/2019
Aggresgate 2,000,000
DEDUCTIBLE 5,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
Certificate holder is additional insured with request to General Liability and
Automobile.
!'`COTICV'`ATC I..InI r1CD rAAIrCI I ATInNI
City Of Fort Collins
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Purchasing Department
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
PO BOX 580
ACCORDANCE WITH THE POLICY PROVISIONS.
Fort Collins, CO 80522
AUTHORIZED REPRESENTATIVE
(O 1986-21)1 U AUL)HU (:UHVUHA I IUN. All rlgnls reserVea.
ACORD25(2010/05) The ACORD name and logo are registered marks of ACORD