HomeMy WebLinkAbout433338 RUSSELL + MILLS STUDIO - INSURANCE CERTIFICATERUSSE-1 OP ID: CK
ACORO
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
09/21/2017
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 terns 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 endorsemen s .
PRODUCER
PUI Agency of Colorado, Inc
PO Box 3412
Littleton, CO 80161-3412
Cindy L. King
NAMEACT Cindy L. Kin
PHONE F
A!c No Ext : 720-465-9116 Arc No).. 248-553-8305
E-MAIL
ADDRESS:
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A: Navigators Insurance Company
42307
INSURED Russell + Mills Studios
INSURER B : Hartford Ins. of the Midwest
37478
506 S. College, Unit A
Fort Collins, CO 80524
INSURER c
INSURER D :
INSURER E :
INSURER F :
CAVFRA[IFS 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,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
OF INSURANCE
L
ADDTYPE
SUOR
POLICY NUMBER
MM DCY EFF
/ EXP
IPOLDD
LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE 7 OCCUR
EACH OCCURRENCE
$
PREMISES Ea occurrence
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY ❑ PRO -
POLICY ❑ LOC
OTHER:
GENERAL AGGREGATE
$
PRODUCTS - COMPIOP AGG
$
$
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
HIRED AUTOS AUTOS
L
COMBINED SINGLE LIMIT
Ea accident
$
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
$
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
—
EACH OCCURRENCE
$
AGGREGATE
$
DED RETENTION $
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y! N
OFFICERIMEMBER EXCLUDED?
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
3SWEC112813
02/04/2017
02104/2018
X STATUTE ER
E.L. EACH ACCIDENT
$ 500,00
E.L. DISEASE - EA EMPLOYEE
$ 500,00
E.L. DISEASE - POLICY LIMIT
$ 500,00
A
Professional Liab
DN17DPLO191311V
09/16/2017
09/16/2018
Ea Claim 2,000,00
Aggregate 2,000,00
DESCRIPTION OF OPERATIONS! LOCATIONS! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
P_FDTICI!_ATr- Nf11 r1C12 CANCFI 1 ATIAN
FTCOLLI
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins
tY
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 580
Fort Collins, CO 80524
AUTHORIZED REPRESENTATIVE
C��`V
9)1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
RUSSE-1 OP ID: CK
ACORO
�, CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDNYYY)
09/21/2017
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
PUI Agency of Colorado, Inc
PO BOX 3412
Littleton, CO 80161-3412
Cindy L. King
CNAOMEACT Cindy L. Kin
PH°NE 720-465-9116 FA/'�c No : 248-653-8305
C No E
EMAIL
ADDRESS:
INSURERS AFFORDING COVERAGE
NAIL #
INSURER A:Navigators Insurance Company
42307
INSURED Russell + Mills Studios
INSURER B : Hartford Ins. of the Midwest
37478
506 S. College, Unit A
Fort Collins, CO 80524
INSURERC:
INSURER D :
INSURER E :
INSURER F :
P1IVG0ArFC r9RTIFIrATF NI IMFtFR- 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,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I�TR
TYPE OF INSURANCE
POLICY NUMBER
MM/D Y EFF
MMOIIDpY�
LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE 7 OCCUR
EACH OCCURRENCE
$
DAMAGE TO RENTEU-
PREMISES Ea occurrence
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY ❑ PRO- ❑
JECT LOC
OTHER:
GENERAL AGGREGATE
$
PRODUCTS -COMP/OPAGG
$
$
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NO OWNED
HIRED AUTOS AUTOS
COMBINED SINGLE LIMIT
Ea accident
$
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
UMBRELLA LIAB
EXCESSLIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
�EXCESS
_d
AGGREGATE
$
F
I I RETENTION $
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N
OFFICERIMEMBER EXCLUDED?
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
3SWEC112813
02JO412017
02/04/2018
X STATUTE ER
E.L. EACH ACCIDENT
$ 5001wo
E.L. DISEASE - EA EMPLOYEE
_
$ 500,00
E.L. DISEASE - POLICY LIMIT
$ 500,00
A
Professional Liab
DN17DPLO191311V
09/15/2017
09/15/2018
Ea Claim 2,000,00
Aggregate 2,000,00
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
f`CRTICIL`ATF Mnl r1FR CONCFI 1. OTION
FTCOLCI
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
CI of Fort Collins
City
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 580
Fort Collins, CO 80522
AUTHORIZED
REPRESENTATIVE
9)1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
RUSSE-1 OP ID: CK
ACORO
CERTIFICATE OF LIABILITY INSURANCE
MroD/YYYY)
0DATEIM / D/YY
017 E (M
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 pollcy(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
PUI Agency of Colorado, Inc
PO Box 3412
Littleton, CO 80161-3412
Cindy L. King
ICIeO,MEA T Cindy L. Kin
PHONE
No Fid : 720-465-9116 No): 248-553$305
ADDRESS:
INSURERS AFFORDING COVERAGE
NAIL>x
INSURER A:Navigators Insurance Company
42307
INSURED Russell + Mills Studios
INSURER B : Hartford ins. of the Midwest
37478
506 S. College, Unit A
Fort Collins, CO 80524
INSURER C
INSURER D :
INSURER E :
INSURER F :
CnVERAGES 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,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
POLICY NUMBER
MMIIDD/YYYY
YYY MMIDD/
LIMITS
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE1:1 OCCUR
EACH OCCURRENCE
$
PRMAGE TO RENT
EMISES Ea occurrence
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY ❑ PRO ❑ LOC
JECT
OTHER:
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
$
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
HIRED AUTOS AUTOS
COMBINED SINGLE LIMIT
Ea accident
$
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
UMBRELLA LIAB
EXCESS LIAB
OCCUR
EACH OCCURRENCE
$
HCLAIMS-MADE
AGGREGATE
$
DED RETENTION $
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N
OFFICER/MEMBER EXCLUDED? ❑
(Mandatory In NH)
If Yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
36WEC112813
02IM2017
02/04/2018
�( STATUT ER H
E.L. EACH ACCIDENT
$ 500,00
E.L. DISEASE -EA EMPLOYEE
$ 500,00
E.L. DISEASE - POLICY LIMIT
$ 500,00
A
Professional Liab
DN17DPLO191311V
09/15/2017
09/15/2018
Ea Claim 2,000,00
Aggregate 2,000,00
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
FTCOLLI
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ty ACCORDANCE WITH THE POLICY PROVISIONS.
Purchasing Division
215 N. Mason Street, 2nd Floor AUTHORIZED REPRESENTATIVE
Box 58 Fort
C
Fort Collins, CO 80522-0580
i
01933-2014 ACOKU CORPORATION. All ngnts reserved.
ACORD 26 (2014/01) The ACORD name and logo are registered marks of ACORD