Loading...
HomeMy WebLinkAbout457580 J F SATO & ASSOCIATES INC - INSURANCE CERTIFICATE (10)CI ient#: 1084594 J F5 ACORDT,- CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 6/16/2015 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 be endorsed. If SUBROGATION IS WAIVW 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 NAME: USI Colorado, LLC Prof Liab aCC, Ext : 800 873-8500 (FAX ac, No): P.O. Box 7050 E-MAIL ADDRESS: Englewood, CO 80155 INSURER(S) AFFORDING COVERAGE NAIC # 800 873-8500 INSURER A: Hartford Casualty Insurance Co 29424 INSURED INSURER B : XL Specialty Insurance Company 37885 J. F. Sato & Associates, Inc. - --- -- — 5878 So. Rapp Street INSURER C : Littleton, CO 80120 INSURER D : - INSURER E : INSURER F : COVERAGES CFRTIFICATF NI IRARFR- Do111C1r%K1 ku iRAOC— 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. LTSRR TYPE OF INSURANCE ADDL INSR_WV_D_� SUBR POLICY NUMBER 34SBWPP2160 POLICY EFF (MM/DD/YYY 01/31/2015 POLICY EXP MM/DD/YYYY LIMITS $1,000,000 A GENERAL LIABILITY X X 01/31/2016 EDAACCHpGOECTCURRENCE X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE �� OCCUR PREMISES Eaocccurrence $300000 MED EXP (Any one person) $10 000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY FXI PRCI" O- JELOC PRODUCTS - COMP/OP AGG $2,000 000 _7 — $ AUTOMOBILE LIABILITY _ _ _ COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS BODILY INJURY Per accident ( ) $ PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB X OCCUR X X 34SBWPP2160 1/31/2015 01/31/2016 EACH OCCURRENCE $8000000 AGGREGATE s8,000,000 EXCESS LIAB CLAIMS -MADE DED I X 1 RETENTION $10000 $ WORKERS COMPENSATION :77WC STATU- OTH- AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN Of-FICER/MEMBEP.EXCLUDED? NIA E.L.ACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ $1,000,000 per claim DESCRIPTION OF OPERATIONS below 7/18/2015 07/18/201 B Professional DPR9723911 Liability $2,000,000 annl aggr. Claims Made DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, 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 is included as Automatic Additional Insured's for your work, acts or omissions which includes completed operations under General Liability and Umbrella Liability but only with respect to liability arising out of the Named Insureds work performed on behalf of the certificate holder and owner. This insurance policies will apply on a primary (See Attached Descriptions) IL�L•JMINARP City of Fort Collins, Purchasing PO Box 580 Fort Collins, CO 80522-0000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) 1 of 2 #S15564213/M15563220 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MDKZP DESCRIPTIONS (Continued from Page 1) and non-contributory basis. A Blanket Waiver of Subrogation applies for General Liability and Umbrella Liability. The Umbrella policy provides excess coverage over General Liability, Automobile Liability and Employers Liability Additional Insured: City of Fort Collins JAU1 I I A ZJ.3 (ZUl U/Ub) Z OT Z #S15564213/M15563220