HomeMy WebLinkAboutENGINUITY ENGINEERING SOLUTIONS INC - INSURANCE CERTIFICATEACO CERTIFICATE OF LIABILITY INSURANCE
DATE(MMmDNYYY)
10/07/19
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 polloy(les) must be endorsed. B 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 endoreemem(s).
PRODUCER .-.
BENCHMARK INSURANCE AGENCY LLC
66 W Springer Dr #215
Highlands Ranch, CO 80129
E: 'MARK R. BEASLEY
. (303) 730-2852 ArCNo:(303)730-2910
ADORESSbenchmarkinsurance90@ ahoo.com
nsaLRtS) AFFORDING coveuae
sacs
.INSURER A: Liberty Mutual
INSURED Enginiiity Engineering solutions, Ind.
10106 W San Juan flay, Suite 215
Littleton, CO 80127
(720) 306-8222
INSURER.B:
wsuRER:c: D
INSURER D:
1NSURER.E:
INSURER F :
/�COrICl/`Are AuuueeD• RFViQlnN NIINIRFR-
vTHIS 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 LS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR
TYPE OF INSURANCE
ZMSA
- POLICY NUMBER
MWDD
M
LIMITS
GENERAL LIABILITY
-
EACH OCCURRENCE
$ 2000000
X COMMERCIAL GENERAL LIABILITY
PREMISES Ee caurrenoe
$ 2000000
MED EXP (Arty one person)
$ 15000
CLAIMS -MADE ® OCCUR
PERSONAL & ADV IWURY
$ 21000,000
A
BZS55143751
/3/2019
/3/2020
2L.
GENERAL AGGREGATE
$ 4000000
GENL AGGREGATE LIMIT APPLIES PER:
PRODUCTS -OOMP/OPAGG
s 4,000,000
$
POLICY PS X T LOC
AUTOMOBILE LIABILITY
Ea accident
2,000,000
BODILY INJURY (Per person)
$
A
ANYAUTO
ALLSWNED AUTOSUULED
NON-OWNED
X HIRED AUTOS FX
g
-
BZS 16-55143751
7/03/2019
7/03/2020
BODILY INJURY(Per acddem)
$
Per.accidem MAUL
$
A
X
UMBRELLA UAB
EXCESS UAB
1 X
OCCUR
CLAIMS -MADE
USO 16-55143751
7/03/2019
7/03/2020
EACH OCCURRENCE
$ 5,000,000
ri
AGGREGATE
$
DED I X I RETENTION $.10 000
_ _
$
_ _
_ _ —
_ _
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
APROPRIETORIPART EROMcInNE Ta
NY
OFFICEPIMEMBER EXCLUDED?
(a=1181*ry In WE.L.
N/A
X
- -
ORTWC
E.L.E.L.. EACH ACCIDENT
$
DISEASE - EA. EMPLOYE
$
E.L. DISEASE - POLICY LIMIT
I $
If Yyes, describe under
DESCRIPTION OFUPERATIONS below
EACH CLAIM 2,000,000
C
PROFESSIONAL E80
ANE1486206.18
9/10/2019
9/10/2020
Aggresgate 2,000,000
DEDUCTIBLE 10,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additbrial Reirrmeft Schedule, if more apace is required)
Certificate holder is additional insured with request to General Liability and
Automobile.
City of Fort Collins
Purchasing Department
PO Box 580
Fort Collins, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED. POLICIES BE CAN BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
01988-2010
ACORD25(2010/05) The ACORD name and logo are registered marks of ACORD
All rights