HomeMy WebLinkAbout542023 GROUP 14 ENGINEERING INC - INSURANCE CERTIFICATE (3)DATE (MMIDD,YYYY)
ACORO® CERTIFICATE OF LIABILITY INSURANCE
7/ 112019
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 CONTACT
NAME: Jamie Falvo
AssuredPartners Colorado PHONE FAX
4582 S. Ulster St., Suite 600 4 303-863-7788 (A/C. No : 303-861-7502
Denver CO 80237 ADDRESS: jamie.falvofassuredpartners.com
INSURED
Groupl4 Engineering PBC
1325 E. 16th Ave.
Denver CO 80218
INSURERS) AFFORDING I
-INSURER A: Sentinel Insurance Co LTD
GROUENG-D1 INSURERS: Pinnacol Assurance
iRD:
11000
41190
Insurance Co. 41718
COVERAGES CERTIFICATE NUMBER: 17RAAARR611 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 A L 8 PO Y Y E7(P
TYPE OF INSURANCE
LTR � WV ', POUCY NUMBER I uwTs
A
X COMMERCIAL GENERAL
Y
34SBAPM3227
5/7/2019
5f7t2020
EACH OCCURRENCE
1 $2.000,000
AMAGE TIRE T
CLAIMS -MADE I X . OCCUR
PREMISES jEa occurrenCO)„__
$-_
MED EXP (Any one person)
$10,000
PERSONAL 3 ADV INJURY
$2,000.000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 4,000,000
POLICY � X I jEa LOC
$4,000,000
PRODUCTS - COMP/OP AGG
$
OTHER.
A
AUTOMOBILE LIABILITY
Y
i 34SBAPM3227
5/7/2019 517121120 COMBINED SINGLE LIMIT
Ea, (_accident)
$2,000,000
--
ANY AUTO
I
BODILY INJURY (Per person)
$
OWNED SCHEDULED
.AUTOS ONLY AUTOS
BODILY INJURY (Per accident)
$
X HIRED NON -OWNED
X
PROPERTYAMAGE
_
$
AUTOS ONLY AUTOS ONLY
'
$
A
X UMBRELLALIAB
X
OCCUR
34SBAPM3227 5!7/2019
5/7/2020 EACH OCCURRENCE
$4,000.000
_
$ 4,000,000
EXCESS UAB
CLAIMS -MADE
AGGREGATE
DIED X RETENTION $ In nno
$
B
WORKERS
EMPLOYERS'BNEOR'EXECUTIVE Y r N
3129038
8/1/2018
8t1t2020
'X i ORH
AND ROPRIIETTMOR ART
jOFFICER'MEMBEREXCLUDED?
NfA
E.L. EACH ACCIDENT
$1,000,000
---------
- -----
E.L. DISEASE_ EA EMPLOYEE
(Mandatory In NH)
$1,000,000
----
II es, describe under
DESCRIPTION OF OPERATIONS below
i E.L. DISEASE - POLICY LIMIT
$ 1,000,000
C !, Professional Liability
I
DPL10009592502 7120/2018 7/20/2019
Professional
2,000,000
1
�
E Professional Aggregat
I
2.000.000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required)
RE Project: Pilot program for mentoring and verifying th QI of HVAC Installations
City of Fort Collins, its officers, agents, and employees are named as additional insureds per written contract,
City of Fort Collins
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
0)1988-2015 ACORD CORPOHATION, All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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