HomeMy WebLinkAboutDAVIS PARTNERSHIP PC ARCHITECTS - INSURANCE CERTIFICATE (3)INS SERV OF CO INC
950 17TH ST STE 1000
DENVER, CO 80202
AM94GRA011YE
COMMERCIAL
CITY OF FORT COLLIN
PO BOX 582
FORT COLLINS, CO 80522
Additional insured endorsement
Name of Person or Organization
CITY OF FORT COLLIN
PO BOX 582
FORT COLLINS, CO 80522
Policy number: 02996964-2
Underwritten by:
Artisan and Truckers Casualty Co
Insured:
DAVID OWEN TRYBA
April 28, 2018
Policy Period: May 1, 2018 - May 1, 2019
Mailing Address
Artisan and Truckers Casualty Co
PO Box 94739
Cleveland, OH 44101
1-800-444-4487
For customer service, 24 hours a day,
7 days a week
The person or organization named above is an insured with respect to such liability coverage as is
afforded by the policy, but this insurance applies to said insured only as a person liable for the conduct of
another insured and then only to the extent of that liability. We also agree with you that insurance
provided by this endorsement will be primary for any power unit specifically described on the
Declarations Page.
Limit of Liability
Bodily Injury Not applicable
Property Damage Not applicable
Combined Liability $1,000,000 each accident
All other terms, limits and provisions of this policy remain unchanged.
This endorsement applies to Policy Number: 02996964-2
Issued to (Name of Insured): DAVID OWEN TRYBA
ARCHITECTS, PC
Effective date of endorsement: 05/01/2018
Form 1198 (01;04)
Policy expiration date: 05/01/2019