HomeMy WebLinkAbout611149 ENGINUITY ENGINEERING SOLUTIONS LLC - INSURANCE CERTIFICATE (2)�i°►� CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
8/23/2018
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
BENCHMARK INSURANCE AGENCY LLC
66 W Springer Dr #215E-MAILbenchmarkinsurance
Highlands Ranch, CO 80129
N A MARK R. BEASLEY
PHONE (303) 730-2852 (303) 730-2910
9 U @yahoo.com
INSURERS AFFORDING COVERAGE
NAIC#
Ohio Casualty Insurance Company
INSURED Enginuity Engineering Solutions, Inc.
10106 W San Juan Way, Suite 215
Littleton, CO 80127
(720)306-8222
INSURER B:
INSURLLOYDS OF LONDON
INSURERD:
INSURER
INSURER
rrC:ornnr'A-rc nn InAf7CIT 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.
LTR
TYPE OF INSURANCE
g
ICYNUMBER
P LI IY F
EP
MOII YYYY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 2,000,000
P I en
MED EXP An one rson
$ 2,000,000
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE ® OCCUR
x
BZS 16-55143751
07/03/2019
�,7/03/2019
$ 15,000
PERSONAL &ADV INJURY
$ 2,000,000
GENERAL AGGREGATE
$ 4,000,000
GEN'LAGGREGATELIMIT APPLIES PER :
PRODUCTS - COMP/OP AGG
$ 4,000,000
X POLICY PRO- LOC$
AUTOMOBILE LIABILITY
COMBINEDSINL LIMIT
r r
BODILY INJURY (Per person)
$
A
ANYAUTO
ALLOWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
X HIREDAUTOS X AUTOS
X
BZS 16-55143751o7/o3/tole
7/03/2019
BODILY INJURY (Pe raccident)
$
PROPERTY DAMA
(Per accident)
$
X
UMBRELLA LIAR
X
OCCUR
USO 16-55143751
07/03/2018
D7/03/20:9
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
A
EXCESS LIAR
CLAIMS -MADE
X I RETENTION$10 000
WORKERS COMPENSATION
X I WC STATU- OTH-
ANDEMPLOYERS'LIABILITY Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE 1�1
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
OFFICER/MEMBER EXCLUDED? U
(Mandatory In NH)
N/A
Y I T
If yes, describe under
N
_OPERATI
EACH CLAIM 1,000,000
C
PROFESSIONAL E&O
ANE1486206 . 18
09/10%2o',a
9/10/2019
Aggresgate 2,000,000
DEDUCTIBLE 5,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, rf more space is required)
Certificate holder is additional insured with request to General Liability and
Automobile.
City of Fort Collins
Purchasing Department
PO 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
n�V/v
U 1966-ZUJU AUUKU GUKF'UNW1IUIN. Hu ngnls reserveU.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD