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Home My WebLink About439705 BELFORD WATKINS GROUP LLC - INSURANCE CERTIFICATE (15)Client#: 1083601 BELFOWAT ACORDTM CERTIFICATE OF LIABILITY INSURANCE —DATE /09/2016 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(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 endorsement(s). PRODUCER CONTACT NAME: USI Colorado, LLC Prof Liab PHONEFAX AAA Lo Ezt : 800 873-8500 A/c No : P.O. Box 7050 Englewood, CO 80155 ADDRESS: 800 873-8500 INSURER(S) AFFORDING COVERAGE NAIL# INSURER A, Sentinel Insurance Company Ltd. 111000 INSURED INSURER B : XL Specialty Insurance Company 137885 Belford Watkins Group, LLC PO Box 1306 INSURER C: INSURER D: 425 W. Mulberry Street, Suite 207 Fort Collins, CO 80522 INSURERE: INSURER F : COVERAGES CERTIFICATE NUMBER- R9:VICInK1 Mnsanco- 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. LTRR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYY LIMITS A XI COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X X 34SBAPM7802 7/08/2015 07/081201C EACH OCCURRENCE $1,000,000 PREMISE SOEaEoccu once $1,000,000 MED EXP (Any one person) $1 O 000 PERSONAL& ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY N JECTT LOC OTHER: GENERAL AGGREGATE PRODUCTS-COMP/OP AGG A AUTOMOBILE LIABILITY X X 34SBAPM7802 7/08/2015 07/08/201 COMBINED SINGLE LIMITEa accident Us2,OOOOOOPRO BODILY INJURY(Per person) ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIREDAUTOS X NON -OWNED AUTOS 80DILY INJURY Per accident ( ) X PROPERTY -DAMAGE Per accident $ $ A )(I UMBRELLA LIAR X OCCUR X X 34SBAPM7802 7/08/2015 07/08/2016 EACH OCCURRENCE $1,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $1 000�000 DED I X I RETENTION $10000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITYTUTE ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICERJMEMBER EXCLUDED? N/A PER I OTH- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) It yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT I $ B Professional DPS9802569 3/15/2016 03/15/201 $1,000,000 per claim Liability $1,000,000 annl aggr. Claims Made DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached 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 and owner are included as Automatic Additional Insured's for ongoing and completed operations under General Liability; Designated Insured under Automobile Liability; and Additional Insureds under Umbrella / Excess Liability but only with respect to liability arising out of the Named Insured work performed on behalf of the certificate holder and owner. (See Attached Descriptions) City of Fort Collins 215 N Mason 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 ACORD 25 (2014/01) 1 of 2 #S17405232/M17402799 V 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD YKSZP DESCRIPTIONS (Continued from Page 1) 1 The General Liability, Automobile Liability, Umbrella/Excess insurance applies on a primary and non contributory basis. A Blanket Waiver of Subrogation applies for General Liability, Automobile Liability and Umbrella/Excess Liability. The Umbrella / Excess Liability policy provides excess coverage over the General Liability and Automobile Liability. Please note that Additional Insured status does not apply to Professional Liability. Additional Insured: City of Fort Collins AA%21I I A ZO.J (ZUl 41Vl) Z OT Z #S17405232/M17402799