HomeMy WebLinkAbout542023 GROUP 14 ENGINEERING INC - INSURANCE CERTIFICATE (2)DATE (MM/Do.'YYYY)
A11i.i CERTIFICATE OF LIABILITY INSURANCE 7/1/2019
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: It 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 CONTACT
NAME: Lamle Falvo
sure artColorado PH°NE , 303-863-7788 Arc.No:303-861-7502
4582 S. Ulsterer S St., Suite 600 E-MAIL
Denver CO 80237 ADDRESS: jamie.faivo(Dassuredpartners.com
INSURED
Group14 Engineering PBC
1325 E. 16th Ave.
Denver CO 80218
GROUENG-01
I INSURER(S) AFFORDING COVERAGE I NAIL # I
A: Sentinel Insurance Co LTD 1 11000
B : Pinnacoi Assurance 41190
c : Endurance America Specialty Insurance Co. 41718
D:
COVERAGES CERTIFICATE NUMBER: 1334695520 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.
INSR ` TYPE OF INSURANCE ADDL'SUBR. POLICY EFF POLICY EXP
LTR ( ID WVD POLICY NUMBER MM/DDIYYYY MM/DDiYYYY LIMITS
A
X COMMERCIAL GENERAL LIABILITY
Y
34SBAPM3227
5T7/2019
517712020 EACHOCCURRENCE
$2,000,000
CLAIMS MADE n OCCUR
AG
PREMISES
MED EXP (Any one person)
$ 10,000
$ 2,000,000
PERSONAL & ADV INJURY
_
$ 4,000,000
GEN'L AGGREGATE 1.81MIT APPLIES PER:
GENERAL AGGREGATE
X
POLICY � LOC
r..---.._...-----------..___..__,._...__.--_-____
PRODUCTS - COMPlOP AGG
$ 4,000,000 _
OTHER:
$
A
AUTOMOBILEUABILRY
Y
34SBAPM3227
5/712019
5/7/2020
(EaaolatleD1SINGLE LIMIT
$2,000.000
$
ANY AUTO
BODILY INJURY (Per person)
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident)
$
X HIRED X j NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Per accident
$
—
I
$
A
Xj UMBRELLA LIAR X : OCCUR
34SBAPM3227 5/7/2019 5/77/2020 EACH OCCURRENCE
$4,000,000
$4,000,000
EXCESS LIAR CLAIMS -MADE
AGGREGATE
$
DED X RETENTION$
B
WORKERS COMPENSATION
AND EMPLOYE ❑
RS'LIABILITY Y l N
YPROPRIETORiPARTNER/EXECUTIVE
OFFICERIMEMBEREXCLUDED?
(Mandatory In NH)
NIA, A
t I
13129038
8/112019 8/112020 X P , O -
� STATUTE ER
�E�L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
$1,000,000
--
If es, describe under
DESCRIPTION OF OPERATIONS below
I
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
C Professional Liability
I
DPLI0009592502 7/20/2018 7/20/2019 Professional
2,000.000
Professional Aggregat
2,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required)
City of Fort Collins. its officers agents. and employees are named as the additional insured per written contract
UtrS 1 Ir'1UA I t MULUtrt UANUtLLA I IUIV
City of Fort Collins
218 N. College Avenue
Fort Collins CO 80526
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
7�.
ACORD 25 (2016/03)
Oc 1988-2015 ACORD CORPORATION. All rights
The ACORD name and logo are registered marks of ACORD
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