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HomeMy WebLinkAboutBOULDER ENERGY CONSERVATION CENTER - INSURANCE CERTIFICATEBOULD-4 OP ID: CT ,acoR>D CERTIFICATE OF LIABILITY INSURANCE 1 DATE (M2/20 7 os/2/2017 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). CONTACT PRODUCER Phone: 970-223-1804 NAME: VolkBell Property & Casualty PHONE FAX 2002 Caribou Drive, Ste. 101 Fax: ac No Ext : AIC No): Fort Collins, CO 80525 E-MAIL Steven G. Smith ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A:CSU Producer Resources Inc INSURED Boulder Energy Conservation INSURERS: Cincinnati Insurance Companies 10677 dba Center for Resource Conservation INSURER c : Pinnacol Assurance 41190 Jeri Scroggins INSURER D : 2639 Spruce Street Boulder, CO 80302 INSURERE: INSURER F : COVFRAGES 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE DDL UBR POLICY NUMBER MM/DDV/YYYY MM DD/YYYY LIMITS LIABILITY EACH OCCURRENCE $ 1,000,00 TO P R E M SES Ea occurrence $ 100,000 RGENERAL COMMERCIAL GENERAL LIABILITY X CS00072159 06/29/2017 06/29/2018 CLAIMS -MADE '�I OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 PRODUCTS -COMP/OP AGG $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: $ 17 POLICY PROT LOC AUTOMOBILE LIABILITY CO MBINED SINGLE LIMIT Ea accident 1000,000 $ i BODILY INJURY (Per person) $ B X ANY AUTO X EPP0336347 06/29/2017 06/29/2018 BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS X X NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,00 B X EXCESS LIAB CLAIMS -MADE X EPP0336347 06/29/2017 06/29/2018 DED I X I RETENTION$ 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N 3305579 10/01/2016 10/01/2017 WC STATU- OTH- X TORY LIMITS ER E.L. EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N I A E.L. DISEASE -_EA EMPLOYE $ 500,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,00 B Property EPP0336347 06/29/2017 06/29/2018 BPP 224,99 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The insurance evidenced by this certificate will not reduce coverage or limits and will not be cancelled, except after 30 days written notice has been received by the City of Fort Collins. I-IUA I t HULULK CITY-02 City of Fort Collins PO Box 580 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 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD