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Home My WebLink About112468 FELSBURG HOLT & ULLEVIG INC - INSURANCE CERTIFICATE (27)Client#: 1084418 FELSBHOL A(;UMU. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 6/13/2017 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 endorsement(s). PRODUCER US1 Colorado, LLC Prof Llab P.O. BOX 7050 Englewood, CO 80155 hJMTeCT PHONE FA AIC 8DO 873-8500 INC,No): E-MAILL ADDRESS: INSURERS) AFFORDING COVERAGE NAIC it 800 873-8500 FelsINSURED Holt & UWay, ,Ina 6300 S. Cent S. Syracuse Way, #600 Centennial, CO 80111 INSURER A: Phoenix Insurance Company INSURER B: Travelers Indemnity Company 25623 25658 INSURER C : Farmington Casualty Company 41483 INSURER D : XL Specialty Insurance Company 37885 INSURER E. Charter Oak Fire insurance Comp 25615 INSURER F : —'""--' --' rlcVIDIVIV NumtstIi: 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 CONTRACTOR 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 ADDL SUBR POLICY EFF LTR TYPE OF INSURANCE INSR WV POLICY NUMBER MM DD YYYY I lNOLICYLWVD EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X X 6802J252902 6/21 /2017 06/21/201 $1 000 000 EEACH�OECCCURRENCE PREMISES EaE�urrence $1 000 000 MED EXP (Any one person) $10 000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 L= I E C LOC OTHER: 6/21 /2017, O6/21/2O1 COMBINED SINGLE LIMIT Ea accident 110001000 E AUTOMOBILE LIABILITY X X BA3008L260 X ANY AUTO BODILY INJURY (Per person) $ ALL OWNEDAHEDULED BODILY INJURY (Per accident) $ AUTOSTOS X HIRED AUTON-OWNED TOS PROPERTY DAMAGE $ Per accident III B X UMBRELLA OCCUR X X CUP654OY22A 6/21/2017 06/21/201 EACH OCCURRENCE $5 000 0O0 EXCESS LIACLAIMS-MADE AGGREGATE $5 000 000 DED X RETENTION $10000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY X UB4281 T356 $ 6/21 /2017 06/21 /2018 X PER OTH- ANY PROPRIETOR/PARTNER/EXECUTIVE Y/ N OFFICER/MEMBER EXCLUDED? � N/A TA TUTE E.L. EACH ACCIDENT $1 OOO OQO Mandatory In NH) ( If yes, describe under E.L. DISEASE - EA EMP$1000000 LOYEE DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000 O0O D Professional Liab X DPR9914986 6/21/2017 06/21/201 $2,000,000 per claim incl Pollution $5,000,000 annl aggr. Claims Made $100,000 Ded Per Claim 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 Insureds 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. (See Attached Descriptions) City of Fort Collins Attn: James B. O'Neill II, CPPO, FNIGP 215 North Mason Street, 2nd Floor Fort Collins, CO 80524-0000 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 ACORD 25 (2014/01) 1 Of 2 #S20689689/M20687738 V 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BHRZP I DESCRIPTIONS (Continued from Page 1) 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 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. RE: Fort Collins Quiet Zone Study Additional Insured: City of Fort Collins SAGITTA 25.3 (2014/01) 2 of 2 #S20689689/M20687738