HomeMy WebLinkAbout611149 ENGINUITY ENGINEERING SOLUTIONS INC - INSURANCE CERTIFICATE (2)coed CERTIFICATE OF
LIABILITY INSURANCE
06/111/20
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
ONLY AND CONFERS NO RIGHTS UPON THE; CERTIFICATE HOLDER. THIS
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
_
IMPORTANT. If the certificate holder is an ADDITIONAL INSURED,Ithe
the terms and conditions of the Policy, certain policies may require
certificate holder In lieu of such endorsement(s).
pollcy(les) must be endorsed. B SUBROGATION IS WAIVED, subiiii-to
an endorsement. A statementan this certificate does not confer rights to the
PRODUCER
BENCHMARK INSURANCE AGENCY LLCIPAU
66 W Springer Dr #215
Highlands Ranch, CO 80129
NAME: MARK �R. BEASLEY
CONE (303j730-2852 rvc"No:(303)730-2910
AODREssb0inchmarkinsurance90@ ahoo.com
ea1LWER(s) AFFOIWM COVERAGE
HMO
INSURER A: Libert ". M__13_tU_ a1
INSURED Enginuity Engineering Solutions,
10106 W San Juan Way, Suite
Littleton, CO 80127
(720) 306-8222
vic.
215
INSURERS: _
NSURFRC:LLOYDS F LONDON_
INSURER D :
INSURER E:
INSURER. F :-
nwcoAr_r=.c r1007lCRr ATC nu uecoc- I RFVI WIN Nl1MRER'
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. uMITS SHOWN!
BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
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.
LTR-
.. „ TYPE OF INSURANCE
WA
wwo
POLICY
NUMBER
MMIDD
MMIDD
-LIMITS
-
GENERAL LIABILITY
EACH OCCURRENCE
$ 2 OOO. 0.00
X COMMERCIAL GENERAL LIABILITY
PREMISES Ea occurrence)$
2 Q00 OQQ
MED EXP (Any one person)
$ 15.0Q0_
CLAIMS -MADE X OCCUR
A
-
x
BZS55143751
7/03/2020
7/03/2021
PERsoNALaADVIN1uRY
_
$ 2, 000,_ -
_ _
GENERAL AGGREGATE
$ 4.000000
GENL AGGREGATE LIMIT APPLIES PER:
PRODUCTS- COMP/OP AGG.
S 4 , 0 00, 000 _
$
X POLICY PRO- LOC
AUTOMOBILE LIABILITY
(Ea acddem .. ....s
2,000,000
BODILY INJURY (Per person)
$
A
ANYAUTO
�OOSWNED SAUT�ULED
X HIRED AUTOS X ANUTOS
X
BzS 16-55143751
D7/03/2020
07/03/2021
BODILY INJURY (Per accident)
$
Per accident
$
$
A
X
UMBRELLA LIAR
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
jJ3O 16-55143751
7/03/2020
D7L03/M21
EACH OCCURRENCE
It 5,000,000
AGGREGATE.
$
DED I X I RETENTION$ 10000
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY TN/
ANY PROPRIETORIPARTPERIEXECUTNE-
OFFICERIMEMBER EXCLLDED4
0110nnetory In fell
X TORY LIMBS R
E.L.EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
E.L.DISEASE -. POLICY. LIMIT
$
If ea, describe under
DESCRIPTION OF OPERATIONS below
_ _
_ _ _
EACH CLAIM 2,000,000
C
PROFESSIONAL Es0
ANE1486206.18
9/10/2019
9/30/2020
Aggresgate 2; 000, 000
DEDUCTIS_LE 10,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES. (Attach ACORD 101, Additional
Certificate holder is additional insured
Remarks Schedule, if more space is required)
with request to General Liability and
Automobile.
n1n11 ,n Arr ur I nen i rANIrFI I ATIMI
City of Fort Collins
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Purchasing Department
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
PO Box 580
ACCORDANCEIWITHTHE POLICY PROVISIONS.
Fort Collins, CO 80522
AUTHORIZED REPRESENTATIVE
®i888-2DTDA( WHDC;UHNUFIAIIVN. AlingritsreServec.
ACORD25(2010/05) The ACORD name and logo are registered marks of ACORD