HomeMy WebLinkAbout570995 ARCHITECTURE WEST LLC - INSURANCE CERTIFICATE (2)OP ID: SC
.4lft ? CERTIFICATE OF LIABILITY INSURANCE
D01/29/20ATE Y6
0112912016
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 pollcy(les) 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 endorsements .
PRODUCER Phone: 970-223-1804
Front Range Insurance Group Fax:
1100 Halton Drive Suite 100
Fort Collins, CO 80525
David A. Wooldridge LUTCFAAI
NAME: CT
PHONE
No E (AIC, No
E-MAIL
ADDRESS:
CUSTOMER IO I: ARCH-34
INSURER(S) AFFORDING COVERAGE
NAIC I
INSURED Architecture West, LLC
Steve Steinbicker
160 Palmer Dr
Ft. Collins, CO 80525
INSURERA: Secura Insurance Companies
22543
INSURERB: Pinnacol Assurance
41190
INSURERC: Beazley Insurance Company, Inc
INSURER D:
NSURERE:
-INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
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 MAYHAVE BEEN REDUCED BY PAID CLAIMS.
LTR
TYPE OF INSURANCE
INSR
POLICY NUMBER
MMIDDIYYYY
MMIDDIYYYY
LIMITS
A
GENERAL LIABILITY
X COMMERCIALGENERALLIARLITY
CLAIMS -MADE FX_1 OCCUR
X
BP-3161262
03/1312016
03/13/2017
EACH OCCURRENCE
$ 1,000,000
_
PREMISES Eeoccurrence
$ 100,000
MED EXP (Any one arson
$ 5,000
PERSONAL& ADV INJURY
S 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
X POLICY PR� LOC
PRODUCTS- COMPIOP AGG
$ 2,000,00
$
A
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNEDAUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
BP-3161262
BP-3161262
03/13/2016
03/1312016
03/13/2017
03/13/2017
COMBINEDSINGLE LIMIT
(Ea accident)
f
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
f
PROPERTY DAMAGE
(Per accident)
$
X
X
$
f
UMBRELLA LIAR
EXCESS UAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
DEDUCTIBLE
RETENTION $
$
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
AICERRRAIETOREXC UDEDCUTIVE Y�
(Mandatory In NH)
If yes. describe under
DESCRIPTION OF OPERATIONS below
NIA
080892
05/01/2015
05/01/2016
X WCSTATU- OTH-
7 RY LIMITS ER
E.L. EACH ACCIDENT
$ 100,00
E.L. DISEASE - EA EMPLOYEE
S 100,00
E.L. DISEASE - POLICY LIMIT
$ 500,00
C
Professional Llab
15ULM150801
07M612015
07/1612016
Each Occu 1,000,000
Aggregate 2,000,00
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If mom space is ra wired)
Holder is listed as an Additional Insured with regards to the General
Liability policy.
CITY OF
City of Fort Collins
215 N. Mason Street, 2nd Floor
Fort Collins, CO 80522
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
O 1908-2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD