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Home My WebLink About343965 IN-SITU INC - INSURANCE CERTIFICATE (3)A� h® CERTIFICATE OF LIABILITY INSURANCE 9ili2015 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 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 Flood and Peterson PO Box 578 Greeley CO 80632 CONTACT Sand SChifferns, CIC NAME: 1r PHONE EXII.(970)266-7107 AC No: (970) 506-6845 na .SSchiffrns@fld eterson.com E-MDREeooP INSURERS AFFORDING COVERAGE NAIC # INSURERAabe - Atlantic Specialty INSURED In -Situ, Inc. 221 E Lincoln Ave Fort Collins CO 80524 INSURER B : INSURERC: INSURERD: INSURER E: INSURER F: ._._ COVFRArFS CERTIFICATE NUMBERICL159105357 � �7 X�163NI:I: [s)ul l d:il 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 TYPE OF INSURANCE ADDL POLICY NUMBER MWDDPOLICYIYYYY EFF MM/D D//YYYY LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxI OCCUR I 7110127690004 9/1/2015 9/1/2016 EACH OCCURRENCE $ 1,000,000 DAMAGE TO R99TED PREMISES Ea occurrence) $ 500,000 MED EXP(Any one person) $ 10,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: MPOLICY PRO F1 LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ AALL AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED X NON -OWNED HIRED AUTOS AUTOS Ix 110127690004 9/1/2015 9/1/2016AUTOSAUTOSBODILY Ee BINEDtSINGLE LIMIT 1,000,000 BODILY INJURY (Per person) $ INJURY (Per accident) $ PROPERTY DAMAGE Peraccident $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 1 P110127690004 9/1/2015 9/1/2016 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED X RETE $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTE IV OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 060411270002 9/1/2015 9/1/2016 X WC STATU- OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 A Other States WC Employers Liability 4060411270002 9/1/2015 9/1/2016 $1,000,000 per Accidentt; per Employee; Policy Limit DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) PCDTICir`ATC Lirli IICD CANCFI I ATIr1N 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. 300 Laporte Ave Fort Collins, CO 80526 AUTHORIZED REPRESENTATIVE S Schifferns, CIC/SSC ACORD 25 (2010105) v T VUU-ZU1 U AL;UKU GUKFUICA I IUN. AN ngnts reservea. INi025 r9ninn51 n1 Thu ar.rion name nnri Innn am raniefnrnrl mnrlre of Ar:rlrin