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103885 COMPUTER SITES INC - INSURANCE CERTIFICATE (5)
ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD YVYY) 07/23/2019 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Kara Smith, CRM, CRIS NAME: Moody Insurance Agency, Inc. HOAX (303) 824-6600 F� No: (303) 370-0118 EMAIL kara.smith@moodyins.com ADDRESS: 8055 East Tufts Avenue INSURER(S) AFFORDING COVERAGE NAIL # Suite 1000 INSURER A: Continental Insurance Company 35289 Denver CO 80237 INSURED INSURER B: Valley Forge Insurance Co. 20508 INSURER C : Plnnacol Assurance 41190 Computer Sites, Inc. INSURER D : Columbia Casualty Company 31127 1225 South Huron St INSURER E : INSURER F: Denver CO 80223-3108 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 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 LTR rypE OF INSURANCE INSD WVD POLICY NUMBER POLICY EXP MMIOD/YYYYX LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS -MADE XOCCUR AMA PREMISES Ea occurrence 1.000,000 5MED EXP (Any one person) S 15,000 rMIDD PERSONAL&ADV INJURY S 1,000,000 A Y 6023017401 08/01/2020 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY � PRO ❑ LOC JECT PRODUCTS-COMP/OP AGG g 2,000,000 $ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident g 1,000.000 BODILY INJURY (Per person) S X ANY AUTO B OWNED SCHEDULED AUTOS AUTOS Y 6023017236 08/01/2019 08/01/2020 BODILY INJURY (Per accident) S PROPERTY DAMAGE Per accitlent 5 XONLY HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 10,000,000 A EXCESS LIAB CLAIMS -MADE 6043289278 08/01/2019 08/01/2020 AGGREGATE S 10,000,000 DIED I XJ RETENTION S 10,000 S C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNERlEXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory In NH) N/A 4107093 08/01/2019 08/01/2020 X1 STATUTE I EERH EL EACH ACCIDENT S 1,000,000 E.L. DISEASE - EA EMPLOYEE S 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS belay E.L. DISEASE - POLICY LIMIT $ 1, 000,000 D Professional Liability CE06043010136 08/01/2019 08/01l2020 Aggregate Limit Per Occurrence Limit 2,000,000 2,000,000 Retention 25,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space Is required) I ANI [ZLLMI IWIV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins Doug Clapp - Senior Buyer ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 580 AUTHORIZED REPRESENTATIVE ��f� Fort Collins CO 80522 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD