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HomeMy WebLinkAbout309311 CAPSTONE INC - INSURANCE CERTIFICATE (3)i� I a A� oRo CERTIFICATE OF LIABILITY INSURANCE DATE (MMID/YYYY) 2/8/2019 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 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 Taggart and Associates, Inc 1680 38th Street, Suite 110 P . 0. BOX 147 Boulder CO 80306 CONTACT NAME: Ellie Jeffers HONE X IPA,C No EXc: (303)442-1484 ac NO: (303)442-8922 E-MAIL elliej@taggartinsurance.com ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: Liberty Mutual Insurance Company INSURED Capstone, Inc. 11001 W. 120th Ave, Suite 220 Broomfield CO 80021 INSURER B: Allied World Surplus Lines INSURER INSURERD: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:19-20 Master 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 MAYBE 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 LTR LT TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD(YYYY POLICY EXP MM /DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE ❑X OCCUR DAMAGE TO RENTED PREMISES 'Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 15,000 BZS57655994 1/6/2019 1/6/2020 PERSONAt. 8 ADV INJURY $ Included GEN'LAGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE $ 2,000,000 X POLICY PRO LOC JECT PRODUCTS - COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BZS57655994 1/6/2019 1/6/2020 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS Hired and Non -Owned $ 1,000,000 X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 8,000 000 AGGREGATE $ 8,000,000 A EXCESS LIAB CLAIMS -MADE DED I X I RETENTION $ 10,000 $ US057655994 1/6/2019 1/6/2020 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN X PER OTH- STATIJ"E ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBER EXCLUDED? (Mandatony Ir NH) ❑ N / A c J ` }^✓d557 _C°9�' 1/ 6/2019 1/6/2020 E L. DISEASE - EA EMPLOYEE $ 1,000,000 It yes, describe under DESCRIPTION OF OPERATIONS below E.L DISEASE - POLICY LIMIT $ 1,000,000 B Errors & Omissions 03067192 06/02/2019 06/02/2020 Aggregate $5,000,000 Each Claim $ 5 , 000 , 000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION Fort Collins Utilities 700 Wood Street P.O. BOX 580 Fort Collins, CO 80522-0580 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 1lie Jeffers/AHS © 1988-2014 ACORD CORPORATION. All riahts reserved ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)