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Home My WebLink AboutBELFORD WATKINS GROUP LLC - INSURANCE CERTIFICATE (2)C I ient#: 1083601 B E LFO W AT ATE ACORD-., CERTIFICATE OF LIABILITY INSURANCE D7/11/2/DD/YYYY) n v2o1 s 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). CONTACT PRODUCER _NAME: FAX USI Insurance Services, LLC (AH_c°N o EXt:800 873-8500 No: P.O. BOX 7050 E-MAIL ADDRES_E: Englewood, CO 80155 INSURER(S) AFFORDING COVERAGE NAN:i 800 873-8500 INSURER A : 5-b-at hrwne,ee Comperrr Let. 11000 INSURED INSURER 9 : XL apeclany Inwnnm COmPNW 37M Belford Watkins Group, LLC INSURER C: PO Box 1306, Fort Collins, CO 80522 INSURER D 425 W. Mulberry Street, Suite 207 - INSURER E :— Fort Collins, CO 80521 INSURER F: CERTIFICATE NUMBER- REVISION NUMBER: COVERAGES 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 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. LTRR TYPE OF INSURANCE INSB SIII POLICY NUMBER MM/DD/VV1'Y MMIDDIYYYY LIMITS A X COMMERCIAL GENERALLIABILnY CLAIMS -MADE X1 OCCUR 34SBAPM7802 7/08/2019 07108/202 EACH s1 000000 GOCCURRENCE PREMIE$SEa oaTunence $1 000000 MED EXP (Any one person) $10 000 PERSONAL B ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s2,000,000 PRODUCTS-COMP/OP AGG s2,000,000 A PRO. —7POLICY L �i JECT C LOC OTHER: AUTOMOBILE LIABILITY 34SBAPM7802 7/08/2019 07/08/202 E°Ma81denNED SINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per aocitleM $ E A X. UMBRELLA LIAB X OCCUR 34SBAPM7802 7/08/2019 07/08/202 EACH OCCURRENCE s1l000 000 AGGREGATE $1 000 000 EXCESS LIAB CLAIMS -MADE CED X RETENTION$10000 WORKERS COMPENSATION PER OTH- $ AND EMPLOYERS' LIASILRY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? (Mandatory In NH) N / A E.L EACH ACCIDENT $ _ E _ E.L DISEASE - EA EMPLOYEE EL DISEASE - POUCY LIMB $ - X yes. describe under DESCRIPTION OF OPERATIONS balm B Professional DPS9939754 3/15/2019 03/15/2021 $1,000,000 per claim Liability $1,000,000 annl aggr. Claims Made DESCRIPTION OF OPERATIONS LOCATIONS VEHICLES (ACORD 101, Additional Remarks Schedule, maybe 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) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 215 N Mason ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE ��) IUoc-LU IJ Hl.Vnu �.vnry nn nvi�. r,u nyn„ ,wc, vw. ACORD 25 (2016.iO3) 1 of 2 The ACORD name and logo are registered marks of ACORD #S26147872/M26147611 SK2ZP