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HomeMy WebLinkAbout457580 J F SATO AND ASSOCIATES - INSURANCE CERTIFICATE (6)JFSAT Client#: 1084594 ACORDTM CERTIFICATE OF LIABILITY INSURANCE M/DDN s/2oDATE (MM/DD/YWI� /2018 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(jes) must have ADDITIONAL INSURED provisions or 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER USI Colorado, LLC Prof Liab P.O. Box 7050 Englewood, CO 80155 CONTACT NAME: PHONE 800 873-8500 FAX (AC, No Ext :(AC, AC No); E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # 800 873-8500 INSURER A : HartfordCasuaky Insurance Co 29424 INSURED J. F. Sato & Associates, Inc. 5878 S. Rapp Street Littleton, CO 80120 INSURER B •_ XL Specialty Insurance Company 37885 INSURER C INSURER D INSURER E 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 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. INSR LTR TYPE OF INSURANCE ADDL INSR SUB WVD POLICY NUMBER POLICPOLICY EXP MM/DDY EFF MM/DD LIMBS A COMMERCIAL GENERAL LIABILITY Y Y 34SBWPP2160 1/31/2018 01/31/2019 EACH $1,000 000 _X CLAIMS -MADE OCCUR �OCCURRENCE PREMISES To RENTED $300OOO MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 F—,] PRO- POLICY JECT LOC PRODUCTS - COMP/OP AGG $ 2,000 ,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ A XI UMBRELLA LIAB 1X OCCUR Y Y 34SBWPP2160 1/31/2018 01/31/201 EACH OCCURRENCE $9 000 000 AGGREGATE $9 00O 000 EXCESS LIAB CLAIMS -MADE DED X i RETENTION $10000 $ _ WORKERS COMPENSATION PER OTH- ISTATUTE ER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N / A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below B Professional Y DPR9927704 7/18/2018 07/18/2019 $1,000,000 per claim Liability $2,000,000 annl aggr. Claims Made DESCRIPTION OF OPERATIONS / LOCATIONS I 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 is included as Automatic Additional Insured's for your work, acts or omissions which includes completed operations under General Liability and Umbrella Liability but only with respect to liability arising out of the Named Insureds work performed on behalf of the certificate holder and owner. This insurance policies will apply on a primary (See Attached Descriptions) I: L•J 11[31q" City of Fort Collins, Purchasing PO Box 580 Fort Collins, CO 80522-0000 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 A �i., r ACORD 25 (2016/03) 1 of 2 #S23319126/M23317193 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MARZP