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309311 CAPSTONE INC - INSURANCE CERTIFICATE (4)
CAPSINC-01 (CLUTE '`o`osr® CERTIFICATE OF LIABILITY INSURANCE DAT6/1/2020�1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION -ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES B LOW CERTIFICATE AFFIRMATIVELY THIS CERT F CATEOFINSURANCE DOES NOT CONSTITUTE. A CONTRACT BETWEEN THE ISSUING'INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CEKnFICATE HOLDER. IMPORTANT:, If the certificate holder isan 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 olicies may require an endorsement A statement on, - P Y this.certificate does.not confer ri hts to the certificate holder lieu of such endorsements . - -- - -' -" PRODUCER C N CT Robin Trelut I Taggggart 8 Assoclatew Inc. PAC "r c, Ear ; 303) 442-1484 1680 38th Street Suite 110 -.-- -- - - E- . rtrelu to artinsurance.com - - - Boulder, CO 80301 INSURERS AFFORDING COVERAGE • NAIC p INSURER A: Ohio Security Insurance Company 24082 INSURED INSURER B: Allied World Surplus Lines Insurance Company 24319 Capstone, Inc. INSURER C : 11001 W. 120th Ave, Suite 220 INSURER D : Broomfield, CO 80021 „awe 601110V10,1 all-IRAM=C3. THIS IS TO CERTIFY THAT THE POLICIES- OF INSURANCE LISTED INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN BELOW HAVE BEEN ISSUED TO THE.INSURED NAMED ABOVE FOR THE POLICY PERIOD JOR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, MAY HAVE BEEN REDUCED BY PAID CLAIMS. TvE OF INSURANCE ADOLSUBR POLICY NUMBER.. POLICY EFF .POLICY.EXP LIMITS rINSR - X COMMERCUIL GENERAL LIABILITY CLAIMS-MADE❑X OCCUR X BZS57655994 ,, , 1/6/2020 116/2021 _ EACH OCCURRENCE 1,000,000 $ PREMISES (Fa occurrence) ETORENTED $ 1,015000MED.EXP An one rson $15000 PERSONAL & ADV.INJURY $ Included � GENT X AGGREGATE LIMIT APPLIES PER: POLICY a j LOC OTHER: GENERAL AGGREGATE--— --2,000,000 .$ PRODUCTS -COMPIOPAGG $ 21000,000 A,. AUTOMOBILELIABWTY OWNED SCHEDULED IXANY AUTO AUgTEO�S ONLY AUUTOSSYLEp AUTOS ONLY X_ AUTOS ON_ LV BZS57655994 1/6/2020 1/6/2021 ED LE.LIMIT,., (Exam dent) .$ 1,000,000 BODILY INJURY PerPerson) $ BRODILY INJURY Per accident -$ PPa�acatle t AMAGE -$ A UMBRELLA LIAB EXCESSLWB X OCCUR CLAIMS -MADE USO57661994 '1/6/2020 116/2021 EACH OCCURRENCE $ 8,000,000 X AGGREGATE $ 8,000,000 DED X RETENTION $ 10,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN OFFIANY CERIM IMRW EXCLUDED? (Mandatory n ER EXCLUDED? (Mandatory n N ) I1 yyes. describe under DESCRIPTIONOF OPERATIONS below NIA XWS57665994 1/6120.20 - 1/61/2021 X PER" OTH- - E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE -EA EMPLOYEE 1,000,000 S E.L. DISEASE -POLICY LIMIT 1'000,006 $ B B Errors 8: Omissions Errors & Omissions 0306-7192 0306-719 1 6/2/2020 6/2I2020 612/2021 61212021 Aggregate Each Occurrence 5,000,000 5,000,000 DESCRIPTION OF OPERATIONS (LOCATIONS /VEHICLES (ACORD 701, Additional Remarks Schedule, may be attached If more space is required) City of Fort Collins is included as additional insured In respect to the General lialblity as required per written contract SHOULD ANY -OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE. THE EXPIRATION DATE 'THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 Fort Collins, CO 80522-0580 AUTHORIZED REPRESENTATIVE 1\� 25 (2616/03) ©1988-2015 ACORD CORPORATION. All rights reserved.. The ACORD name and logo are registered marks of ACORD