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HomeMy WebLinkAboutHUMPHRIES POLI ARCHITECTS PC - INSURANCE CERTIFICATEClient#: 1084379 HUMPHPOI ACORDIM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 1 6/05/2019 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER US[ Insurance Services, LLC P.O. Box 7050 Englewood, CO 80155 800 873-8500 CONTACT NAME: PHONE g00 873-8500 FAX A/C, No, Ext : A/C, No : E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURER A •Hartford Casualty Insurance Company 29424 INSURED Humphries Poli Architects, PC 1655 Grant St INSURER B • Admiral insurance Company 24856 rwd INSURER C :Hartford Undeters Insurance Co. 30104 Denver, CO 80203 INSURER D : INSURER E INSURER F : 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 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. LTR TYPE OF INSURANCE ADDLSUBR NSR WVD POLICY NUMBER MM/DDYIYYYY MM/DDY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY X X 34SBWGC5644 6/02/2019 06/02/202 EACH OCCCURRENCE $1 000 000 CLAIMS -MADE OCCUR $ 300 000 PREMISES EaEocceu ence MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY � JECOTI LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: C AUTOMOBILE LIABILITY X X 34UEGPO5860 6/02/2019 06/02/202 COMBINED SINGLE LIMIT Ea accident 1,000e000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ X HIRED ONLY X NON -OWNED AUTOS ONLY A X UMBRELLA LIAB X I OCCUR X X 34SBWGC5644 6/02/2019 06/02/2020 EACH OCCURRENCE s2,000,000 AGGREGATE s2,000,000 EXCESS LIAB CLAIMS -MADE DED X', RETENTION $10000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? El N/A PER OTH- ISTATUTE E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below _ E000002921505 E.L. DISEASE -POLICY LIMIT $ 12,000,000 per claim B Professional _ 6/02/2019 06/02/2020 Liability $4,000,000 annl aggr. Claims Made DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached 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) City of Fort Collins Attn: Purchasing Dept. PO Box 580 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 (2016/03) 1 of 2 #S25828716/M25827891 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MYPZP