HomeMy WebLinkAboutRB + B ARCHITECTS - INSURANCE CERTIFICATE (2)OP ID: SC
.4coRn CERTIFICATE OF LIABILITY INSURANCE DATE/
�►�--�'� 05/0101 /2017Y)
017
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).
PRODUCER Phone: 970-223-1804 CONTACT
Front Range Insurance Group PHONE FAX
1100 Haxton Drive Suite 100 Fax: A/c No Ext : A/C No):
Fort Collins, CO 80525 E-MAIL
David A. Wooldridge LUTCFAAI PRODUCER f`IICTnUrR.n.. RB&BI-1
INSURER(S) AFFORDING COVERAGE NAIC #
INSURED RB+BArchitects, Inc. INSURERA: RLI Insurance Company
Corky Bradley
INSURER B
315 E Mountain Ave, Ste 100
Fort Collins, CO 80524 INSURER c
INSURER D :
INSURER E :
INSURER F
rr1VFRArFC rFRTIFIrATF NIIMRFP- RFVI.ginN NIIMRFR-
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
ADDL
UB
POLICY NUMBER
MMLDD/YYVY
EXP
MMLDDYIYYYY
LIMITS
A
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE � OCCUR
X Prof Liab
X
PSB0007002
RDP0028834
05/01/2017
05/01/2017
05/01/2018
05/01/2018
EACH OCCURRENCE
$ 1,000,00
DAMAGE TO RENTED
PREMISES Ea occurrence
$ 300,00
ME EXP (Any one person)
$ 5,00
PERSONAL & ADV INJURY
$ 1,000,00
GENERALAGGREGATE
$ 2,000,00
GEN'L AGGREGATE LIMIT APPLIES PER:
RO- LOC
POLICY X P
I PRODUCTS - COMP/OP AGG
$ 2,000,00
Prof Liab
$ 2M/3
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
X
PSA0002026
05H5/2017
05/01/2018
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,00
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
X
X
$
A
X
UMBRELLA LIAB
EXCESS LIAR
X
OCCUR
CLAIMS -MADE
PSE0003510
05/01/2017
05/01/2018
EACH OCCURRENCE
$ 3,000,00
X
AGGREGATE
$ 3,000,00
DEDUCTIBLE
RETENTION $
$
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? ❑
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
WC STATU- OTH-
TORY LIMITS ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE- POLICY LIMIT
-$
$
A
Bus Pers Prop/TIB
�PSB0007002
05/01/2017
05/01/2017
05/01/2018
05/01/2018
BPP/TIB 1,010,70
Bus Inc ALS
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
City of Fort Collins has been named as Additional Insured
with respects to the General Liability and Auto Liability
Policies
r9PTIGIr ATF Wnl r1FR rANrFI I ATION
CITYF05
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Fort Collins
Purchasing Division
215 North Mason Street
AUTHORIZED REPRESENTATIVE
Fort Collins, CO 80522
U 1988-2UU9 AGURD GURPORATIUN. All rights reserved.
ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD