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Home My WebLink About20102913.tiff ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) '`� p 11/24/2010 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.: - r IMPORTANT: If the certificate holder is an ADDITIONAL.INSURED,The:jioIicy(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 I_- C04FABTLI MARSH USA INC. PHONE FAX - _J WAME: TWO LOGAN SQUARE (WC.No EMI: (A/C,No): PHILADELPHIA,PA 19103-2797 E-MAIL Attn:Comcast.Certs@marsh.com Fax:212-948-0360 _,. PADDRESS:R CUSTOMER ID 5- 05194-ALL-GAWU-10-11 COMCA DENVE CO INSURER(S)AFFORDING COVERAGE NAIC a INSURED INSURER A:ACE American Insurance Company 22667 COMCAST OF CALIFORNIA/COLORADO/TEXAS/ ACE Properly And Casualty Ins Co 20699 4700 5.SYRACUSE STREET,SUITE INSURER B: DENVER,CO 80237 INSURER c:Indemnity Ins Co Of North America 43575 INSURER 0: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: CLE-002825072-14 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTRNSA WVD POLICY NUMBER (MWDD/YYYY) (MM/DOI'YYYY) GENERAL LIABILITY EACH OCCURRENCE $ 4,900,000 A X COMMERCIAL GENERAL LIABILITY XSL G25521699 12/01/2010 12/01/2011 DAMAGE TO RENTED PREMISES(Ea occurrence) $ 4,900,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 4,900,0110 X $100,000 SIR GENERAL AGGREGATE $ 25,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS'COMP/OP AGG $ 6,000,000 X I POLICY 7 JEPRO CT- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 10,000,000 A X ISA H08631293 12/01/2010 12/01/2011 (Ea acciden() ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Per accident) $ NON-OWNED AUTOS $ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,1700 B I EXCESS LIAB XOO G24875313 12/01/2010 12/01/2011 5000000 CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ C WORKERS COMPENSATION WLRC46142287(AOS) 12/01/2010 12/01/2011 X WCSTATU. 0TH- AND EMPLOYERS'LIABILITY TORY I IMITS FR A ANY PROPRIETOR/PARTNER/EXECUTIVE YNN N/A WLRC46142263(CA) 12/01/2010 12/01/2011 E.L.EACH ACCIDENT $ 2,000,000 A (Mandatory NH)EXCLUDED? WLRC46142275(MN) 12/0112010 12/01/2011 2,000,000 M in NH) E.L.DISEASE-EA EMPLOYEE $ _ A Il yes describe under SCFC46142299 WI 17701/2010 12/01/20112,000,600 DESCRIPTION OFOPERATIONS below ( ) E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) TERM OF CONTRACT:8/16/00-8/15/2012. CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED AS RESPECTS THE GENERAL LIABILITY POLICY WHERE REQUIRED BY WRITTEN CONTRACT WITH THE NAMED INSURED.$100,000 PER OCCURRENCE SELF INSURED RETENTION APPLIES ONLY TO THE ABOVE GENERAL LIABILITY POLICY. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE WELD COUNTY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BOARD OF COUNTY COMMISSIONERS ACCORDANCE WITH THE POLICY PROVISIONS. ATTENTION COUNTY CLERK 915 10TH STREET AUTHORIZED REPRESENTATIVE GREELEY,CO 00632 of Marsh USA Inc. lAY`NYYIU U tiVAl ONS JAMES B.HATCH nn'e e r�JPy)j�Oa la-13—ID ®1988-2OO9 ACORD CORP( ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD 2010-2913 ACORD CERTIFICATE OF LIABILITY INSURANCE DATE 12010 YYYY) 11/2412010 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. I.1. -, 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 po14ciep may.require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). -- _ f!- PRODUCER CONTACT MARSH USA INC. NAME:PHO E FAX TWO LOGAN SQUARE - (NC"No EMI' I(NC.No): PHILADELPHIA,PA 19103-2797 -` ' -' -E-MAIL ADDRESS: Attn:Comrast.Cerls@marsh.com Fax:212-948-0360 PRODUCER CIISTOMFR ID X: 05194-ALL-GAWU-10-11 COMCA DENVE CO INSURER(S)AFFORDING COVERAGE NAICa INSURED INSURER A:ACE Amedcan Insurance Company 22667 COMCAST CABLEVISION OF COLORADO I,LLC ACE Properly And Casualty Ins Co 20699 8000 EAST ILIFF AVENUE INSURER B: DENVER,CO 80231 INSURER C:Indemnity Ins Co Of North America 43575 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: CLE-002822230-15 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTRINSR WVD POLICY NUMBER IMM/DD/YYYYI (MWDD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ 4,900,000 A X XSL 625521699 12/01/2010 12101/2011 DAMAGE TO RENTED PREMISES(Ea occurrence) $ 4900,000 COMMERCIAL GENERAL LIABILITY ICLAIMS-MADE X OCCUR MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 4,900,000 X $100,000 SIR GENERAL AGGREGATE $ 25.000,000 GENII_AGGREGATE LIMIT APPLIES PER: PRODUCTS.COMP/OP AGG $ 6,000,000 POLICY JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 10,000,000 A X ISA H08631293 12/01/2010 12/01/2011 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ $ X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 5,000,000 B EXCESSLIAB X00624875313 12/01/2010 121012011 AGGREGATE $ 5,000,000 CLAIMS-MADE DEDUCTIBLE $ RETENTION $ $ C WORKERS COMPENSATION WLRC46142287(AOS) 12/01/2010 12/01/2011 X I WCSTATU- I IOTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER A YIN WLRC46142263 CA 12/01/2010 12/01/2011 2,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE CUTIVE N N/A ( ) E.L.EACH ACCIDENT $ oFFIdalary in H)EXCLUDED? WLRC46142275(MN) 12/01/2010 12/01/2011 E.L.DISEASE-EA EMPLOYEE $ 2,000,000 A (Mandatory NH) A II yes describe under SCFC46142299(WI) 12/01/2010 12/01/2011 2,000,000 DESCRIPTION CF OPERATIONS below E.L.DISEASE POLICY LIMIT § DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) TERM OF CONTRACT: 2/26196-2/26/2011. CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED AS RESPECTS THE GENERAL LIABILITY POLICY WHERE REQUIRED BY WRITTEN CONTRACT WITH THE NAMED INSURED.$100,000 PER OCCURRENCE SELF INSURED RETENTION APPLIES ONLY TO THE ABOVE GENERAL LIABILITY POLICY. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE WELD COUNTY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BOARD OF COUNTY COMMISSIONERS ACCORDANCE WITH THE POLICY PROVISIONS. ATTENTION COUNTY CLERK 915 10TH STREET AUTHORIZED REPRESENTATIVE GREELEY,CO 80632 of Marsh USA Inc. JAMES B.HATCH /-s"-e- e 'Pe-C>4. ['A/ l iAt C0VV01/15 )a_ t 3_j O ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD Hello