HomeMy WebLinkAbout- INSURANCE CERTIFICATE (9)ACORnn CERTIFICATE OF LIABILITY INSURANCE 06/28104°°'""'
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Van Gilder Insurance Corp. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
700 Broadway, Suite 1000 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver, CO 80203
303 837-8500 INSURERS AFFORDING COVERAGE
INSURED INSURERA:St. Paul Insurance (Med/A&E)
Felsburg Holt & Ullevig, Inc. INSURER B:Hartford Insurance Group
6300 S. Syracuse Way, #600 INSURER c: Hartford Insurance (Service Center)
Centennial, CO 80111 INSURER D:XL Specialty Insurance Company
I INSURER E:
('AVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ImPOLICY
TYPEOFINSURANCE
POLICY NUMBER
EFFECTIVE
p
POUCYEXPIRATION
M/ QM
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
1 CLAIMS MADE OCCUR
BKO1421523
05/01/04
05/01/05
EACH OCCURRENCE _
�$1,000,000
FIRE DAMAGE (Any one fire:
$1,000,000
ME D EXP(Any one person)
$10,000
PERSONAL & ADV INJURY
$1,000,000
GENERAL AGGREGATE
s2 000,000
_
GEN'LAGGREGATE LIMIT APPLIES PER:
1-1 JFCT POLICY PRC- n LOC
PRODUCTS-COMP/OP AGO
$2 00O 000
B
AUTOMOBILE
LIABILITY
ANYAUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON -OWNED AUTOS
34UECFW5245
05/01/04
05101/05
`Oa BIIde D)SINGLE LIMIT
$1,000,000
X
BODILY INJURY
(Per parson)
$
X
BODILY INJURY
(Peraccident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GAR AGE LIABILITY
ANY AUTO
AUTO ONLY -EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
A
EXCESSUABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION $
BKO1421523
05/01/04
05/01/05
EACH OCCURRENCE
s4,000,000
AGGREGATE
$4 000,000
$
$
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
34WEGKC2800
05/01/04
05/01/05
X WCSTATU- OTH-
E.L. EACH ACCIDENT
s500,000
E.L. DISEASE -EA EMPLOYEE
$500,000
E.L. DISEASE -POLICY LIMITI
$500,000
D
(OTHER Architects &DPR9401794
ngineers
Professional Liab
06/21/04
06/21/05
$2,000,000 per claim
$4,000,000 annl aggr.
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY EN DORSEMENT/SPECIAL PROVISIONS
RE: #P-768 North College Corridor Improvements Phase I
City of Fort Collins
Administrative Services -Purchasing
215 N Marson St.,2nd Floor
PO Box 580
Fort Collins, CO 80522-0580
SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF,THE ISSUING INSURER W I LLEN DEAVORTO MAI L3.0_— DAYS WRITTEN
NOTICETOTHE CERTIFICATE HOLDER NAMED TOTHE LEFT, BUr FAILURE TODOSOSHALL
IMPOSE NOOBLIGATION OR LIABILITY OFANYKIND UPON THE INSURER, ITS AGENTS OR
D REPRESENTATIVE
Arnen ec_e 17®7%. _.. �..