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Home My WebLink About330179 INTERWEST CONSULTING GROUP - INSURANCE CERTIFICATE (22)CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 11/14/2017 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 endorsements . PRODUCER USI Colorado, LLC Prof Liab P.O. Box 7050 Englewood CO 80155 CONTACT NAME: KathyStar _ PHONE 800-873-8500 FAx E-MAIL ADDRESS - INSURER S AFFORDING COVERAGE NAIC # INSURERA:XL Specialty Insurance Company 37885 INSURED INTERCON35 Interwest Consulting Group P.O. Box 18330 Boulder CO 80308 INSURER B: Travelers Property Cas. Co. of Amer 25674 INSURERC:Travelers Indemnity Co. of America 25666 INSURERD: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMRI R• 1058682RRn RCYIJIVIY Ivumocic: 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. INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLIC MMIDDY EFF MM DDY EXP LIMITS C X COMMERCIAL GENERAL LIABILITY Y Y 6806H441143 11/14/2017 11/14/2018 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES Eaoccu once — $1,000,000 CLAIMS -MADE OCCUR MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 POLICY JECOT- � LOC OTHER: $ B AUTOMOBILE LIABILITY Y Y BAOJ093233 11/14/2017 11/14/2018 COMBINED SINGLE LIMIT$ Ea accident 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per BODaccident) $ AUTOS AUTOS HIRED AUTOS X NON -OWNED X AUTOS PROPERTY DIAMAGE $ Per accident B X UMBRELLA LIAB OCCUR Y Y CUP2F178249 11114/2017 11/14/2018 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 EXCESS LIAB ---- CLAIMS -MADE DED X $ 0 .RETENTION $ B WORKERS COMPENSATION Y UB8J034006 11/14/2017 11/14/2018 X IPER OTH- AND EMPLOYERS' LIABILITY YIN STATUTE I I ER E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N /A E.L. DISEASE - EA EMPLOYE — $1,000,000 (Mandatory in If yes, describe under '�. E.L. DISEASE -POLICY LIMIT _ $1,000,000 DESCRIPTION OF OPERATIONS below ssional Liability Y DPR9919387 11/14/2017 11/14/2018 Per Claim$2,OOQ000 7,pp'l.-I ion Liab Included s Made 1 Annual Aggregate $5,000,000 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 Insured's 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. 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, Umbrella/Excess Liability and Workers Compensation. The Umbrella / Excess Liability policy See Attached... City of Fort Collins Attn: Purchasing Department P.O. Box 580 Fort Collins CO 80522 trM1Y V CLLF1 1 1 V IY 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 U 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 4COR0� AGENCY CUSTOMER ID: INTERCON35 LOC #: A r%r11T1/'%K1 A I OC11A A MIlc+ c+nucl�l 11 .vv• • •v•�i--�� ■`�•�•i--�IV�V VVI ILL.JV LL rayo v• AGENCY NAMED INSURED USI Colorado, LLC Prof Liab Interwest Consulting Group P.O. Box 18330 POLICY NUMBER Boulder CO 80308 CARRIER NAIC CODE EFFECTIVE DATE: AUU• • IUNAL KtMAKr b THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE provides excess coverage over the General Liability, Automobile Liability and Employers Liability. Please note that Additional Insured status does not apply to Professional Liability or Workers' Compensation Certificate Holder is additional Insured with respect to General Liability and Automobile. All policies include Thirty (30) Day Notice of Cancellation in favor of the City of Fort Collins. V 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD