HomeMy WebLinkAbout114721 INTERMOUNTAIN COLOR DBA SIGNATURE OFFSET - INSURANCE CERTIFICATE (3)ACORD, CERTIFICATE OF LIABILITY INSURANCE
9/30/2015
DATE(MM/DD/YYYY)
9/29/2015
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
CONT CT
NAME:
PHONE
A/C, No, Ext : A/C, No):
E-MAIL
ADDRESS:
INSURER(SI AFFORDING COVERAGE
NAIC #
(303) 414-6000
INSURER A : The Hanover American Insurance Company
36064
INSURED Intermountain Color, Inc.
1038155 dba Signature Offset
4900 Pearl E. Circle, Suite 300E
Boulder, CO 80301
INSURER B : Allmerica Financial Benefit Insurance Co
41840
INSURER C: Massachusetts Bav Insurance Company
22306
INSURER D: The Hanover Insurance Com anv
22292
INSURER E:
INSURER F :
COVERAGES INTCO01 CERTIFICATE NUMBER: 11085819 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
IN D
SUBR
WVD
POLICY NUMBER
POLICY EFF
MMIDDIYYYY
POLICY EXP
MM/DDIYYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
Y
N
ZZ4A432687
9/30/2015
9/30/2016
EACH OCCURRENCE
1,000,000
CLAIMS -MADE OCCUR
PREMISES (E. oCc . ante
500,000
MED EXP (Any oneperson)
10,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER.
POLICY❑ PRO-
JECT ❑ LOC
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ Included
$
OTHER
B
AUTOMOBILE
LIABILITY
Y
N
AW4A432811
9/30/2015
9/30/2016
COEe aocld DiSINGLE LIMIT
$ 1,000,000
BODILY INJURY (Per person)
$ }(}(�{}{XXX
C
ANY AUTO
AUTOS NED AUTODULEDBODILY
AD4A417866 (MS)
9/30/2014
9/30/2015
Ix
INJURY (Per accident
$ XXXXXXX
PROPERTY DAMAGE$
PeraccidentComp/Coll
XXXXXXX
NON -OWNED
HIRED AUTOS AUTOS
$ XXXXXXX
}( Ded $500
D
X
UMBRELLA LIAB
X
OCCUR
N
N
UH4A432688
9/30/2015
9/30/2016
EACH OCCURRENCE
$ 4,000 000
AGGREGATE
$ 4.000.000
EXCESS LIAB
I
JCLAIMS-MADE
DIED I RETENTION $
$ XXXXXXX
1
C
WORKERS COMPENSATION
AND EMPLO ERS' L ABILIITY Y / N
ANV PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? N
(Mandatory in Ni
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
N
WD4A417223
9/30/2015
9/30/2016
X STATUTE GTH-
I
E.L. EACH ACCIDENT
$ 500,000
E.L. DISEASE - EA EMPLOYEE
500,000
E.L. DISEASE - POLICY LIMIT
500,000
A
Printer's E&O
N
N
ZZ4A432687
9/30/2015
9/30/2016
$1,000,000 Ea Wrongful Act
$1,000,000 Aggregate
$5,000 Ded
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: 7070 Printing & Distribution Services - The City of Fort Collins, its officers, agents and employees are additional insured but only as respects work
performed and/or services provided by the named insured.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
11085819 AUTHORIZED REPRESENTATIVE
City of Fort Collins
Purchasing Division
P.O. Box 580
Fort Collins CO 80522
ACORD 25 (20141011 198812014 ACORD CORPO ATION. All riahts reserved
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