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THE BAUEN CORPORATION - INSURANCE CERTIFICATE (9)
ACORD, CERTIFICATE OF LIABILITY INSURANCE 5/12016 DATE(MM/DD/YYYY) 41/29/2015 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 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 Lockton Companies 8110 E Union Avenue Suite 700 Denver CO 80237 CONTACT NAME: _PTF5Rr FAT A/C, No Ext : (A/C, No E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # (303) 414-6000 INSURER A : The Continental Insurance Company 35289 INSURED The Bauen Corporation 1034092 801 E. 52nd Ave. Denver, CO 80216 INSURER 8 : Continental Casualty Company 20443 INSURER C : Pinnacol Assurance Company 41 190 INSURER D : AXIS Surplus Insurance Company 26620 INSURER E: INSURER F : COVERAGES BAUC003 CERTIFICATE NUMBER: 1991907 REVISION NUMBER: XXXXXXX 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 INSD SUBR WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Ex] }( N N 4021109791 5/1/2015 5/l/2016 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence 1 00,000 MED EXP (Any oneperson) 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICYa PECOT- ❑ LOC OTHER GENERAL AGGREGATE $ 2,000 000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO AUTOS NED AUTOSULED NON -OWNED HIRED AUTOS X AUTOS N N 4021 110598 5/1/2015 5/1/2016 COBINEDaccidentSINGLE LIMIT $ 11000,000 BODILY INJURY (Per person) $ XXXXXXX IR BODILY INJURY (Per accident $ XXXXXXX PROPERTY DAMAGE$ Per accident XXXXXXX $XXXXXXX B X UMBRELLALIAB EXCESS LAB NOCCUR CLAIMS -MADE N N 4021109807 5/1/2015 5/1/2016 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED I I RETENTION $ $ XXXXXXX C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN OFFICER/MEM ER EXCLUDED? ECUTIVE N❑ (Mandatory in NH) 11 yes, de —be under DESCRIPTION OF OPERATIONS below N / A I N I 2127630 I 10/1/2015 10/1/2016 TH- X STATUTEANYOFIR E.L. EACH ACCIDENT $ 1 .000,000 E.L. DISEASE - EA EMPLOYEE 1,000,000 [E—,DISEASE - POLICY LIMIT 1.000.000 D Pollution Liability N N ESZ763587 5/1/2015 5/1/2016 Limit: $1,000,000 each claim Ded:$10,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required) L,tK I IFIL:A I t MULUtK GANUtLLA I ILIN See Attacnments SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1991907 AUTHORIZED REPRESENTATIVE City of Fort Collins P.O. Box 580 Fort Collins CO 80522 ACORD 25 (2014/01) ©1 M812014 ACORD CORPO ATION. All rights reserved The hr('IPr1 n— and Innn orn rnnicfcrnfll marlec of Arr)Ar1