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HomeMy WebLinkAbout127605 SKUMATZ ECONOMIC RESEARCH ASSOCIATES INC - INSURANCE CERTIFICATE (6)A� CERTIFICATE OF LIABILITY INSURANCE
2�l �20 7)
THIS CERTIFICATEIS 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 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 rights to the certificate holder in lieu of such endorsements .
PRODUCER
TAGGART & ASSOCIATES INC/PHS
342321 P: F:
PO BOX 33015
SAN ANTONIO TX 78265 I
CONTACT
NAME:
PHONE
FAX
ADDRESS:
INSURER(S) AFFORDING COVERAGE NAICu
INSURERA: Hartford Casualty Ins CO
INSURED
SKUMATZ ECONOMIC RESEARCH ASSOCIATES,
INC-
762 ELDORADO DR STE 100
SUPERIOR CO 80027
INSURERB: Twill City Fire Ins CO
INSURERC:
INSURER D :
INSURER E:
INSURERF
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 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,EXCLUS IONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
117VSR
IYPE DFINSURANCE
ADDL
SUER
POLICYNUMBER
Folu("YEFF
POLICYEXf'
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
21 0 0 01 0 0 0
CLAIMS -MADE � OCCUR
DAMAGE TO
PREMISESS ( (Ea occurrence)
v 300,000
X
X
MED EXP (Any one person)
5101 000
A
General L1ab
34 SBA PA5100
03/12/2017
03/12/2018
PERSONAL & ADV INJURY
72, 000, 000
GEN'L
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
4, 000, 000
POLICY PRO-
❑X LOC
PRODUCTS - COMPIOP AGG
; 4 t 0 0 0 , 0 0 0
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
(Ea accident)
52 O O O O O O
r i
BODILY INJURY (Per person)
ANY AUTO
A
OWNED SCHEDULED
AUTOS ONLY AUTOS
34 SBA PA510 0
03/12/2017
03/12/2018
BODILY INJURY (Per accident)
;
PROPERTY DAMAGE
(Per accident)
X HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
UMBRELLA L1AB
OCCUR
EACH OCCURRENCE
EXCESS LIAR
CLAIMS -MADE
AGGREGATE
DE
RETENTION's
ffi0l7Ke RY COd0EN5a71n N
R.VD ENPLO:ERY'LL4M rry
PER OTH-
X STATUTE ER
ANY PROPRIETORIPARTNERIEXECUT'IVEYIN
E.L. EACH ACCIDENT
' 1 000Q
B
OFFICERMEMBEREXCLUDED?
(Mandatory in NH) ❑
IVA
34 WEC GM5199
03/12/2017
03/12/2018
E.L. DISEASE-EAEMPLOYEE
'1� 000, 000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
`]„ 0 0 0 , 0 0 0
DESCRIPTION OF OPERA TIONS/LOCATIONS/VEHIC(NORD 101, Additional Remarks Schedule, may be attached if more space is required)
Those usual to the Insured's Operations.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
City of Fort Collins
Y
BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE
DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS-
Attn: James B . O'Neill
AUTHORIZED REPRESENTATIVE `
PO Box 580
-
Fort Collins, CO 80522
c01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD