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Home My WebLink About330179 INTERWEST CONSULTING GROUP - INSURANCE CERTIFICATE (23)ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1 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: Kath Star FAX jA/CONNo F:t), 800-873-8500 (Arc No): E-MAILADDRESS INSURERS AFFORDING COVERAGE NAIC # INSURER A:XL SDecialty Insurance Company 37885 INSURED INTERCON35 INSURERS: Travelers Property Cas. Co. of Amer 25674 Interwest Consulting Group P.O. Box 18330 INSURERC:Travelers Indemnity Co. of America 25666 INSURER D Boulder CO 80308 INSURER E INSURER F : COVERAGES CFRTIFICATF MIIMRFR• R53671fiR MCl/ a .1.. rn. 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. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM DDY EFF MM/ Dt POLICY EXP LIMITS C X COMMERCIAL GENERAL LIABILITY -----1 Y Y 6806H441143 11/14/2017 11/14/2016 EACH OCCURRENCE $1,000,000 CLAIMS -MADE I X OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $1,000,000 _ MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 x POLICY FX7 PRO- JECT LOC PRODUCTS - COMP/OP AGG $2,000,000 OTHER: B AUTOMOBILE LIABILITY Y Y BAOJ093233 11/14/2017 11/14/2018 COMBIN D SINGL LIMIT Ea accident $1,000,000 X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS %� PROPERTY DAMAGE Per accident $ $ B X UMBRELLA LIAB HOCCUR Y Y CUP2F178249 11/14/2017 11/14/2018 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 EXCESS LIAB CLAIMS -MADE DED X RETENTION$0 $ B li WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y UB8J034006 11/14/2017 11/14/2018 X STATUTE EERH YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ N I A E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under --- - E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS below $1,000,000 A Professional Liability Y DPR9919387 11/14/2017 11/14/2018 Per Claim $2,000,000 Pollution Liab Included Annual Aggregate $5,000,000 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 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 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 (2014/01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: INTERCON35 LOC #: A r%r%ITIr%AI A I MCRA A ^0• I I. ! I .■ %��. — 1 91v11qr1L- 11k`1T1r%I%r%V ♦7VflCUVLC rage 1 OT I AGENCY NAMED INSURED USI Colorado, LLC Prof Liab Interwest Consulting Group POLICY NUMBER P.O. Box 18330 Boulder CO 80308 CARRIER 7��i EFFECTIVE DATE: 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 [Uus ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD