Laserfiche WebLink
<br /> Client#: 114704 ADVANCEDSY <br /> ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDYYW) <br /> 12/03/201 O <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(tes) must be endorsed. If SUBROGATION IS WAIVED, subject to <br /> the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> PRODUCER NAME: Neena Hagans <br /> Haylor Freyer & Coon, Inc. PHONE 303 465-0986 <br /> 2655 West Midway Blvd_ aC No Ezt : ac, No : 303 410-9992 <br /> ADDRESS: nhagans@haylor.com <br /> Suite 215 N-2010-111 DDU ADVANCEDSY <br /> Broomfield, CO 80020 CUSTOMER ID <br /> INSURER(S) AFFORDING COVERAGE NAIL # <br /> INSURED <br /> Virtual Enterprises In INSURER A: Great Northern Insurance Co. <br /> dbe: Advanced Systems Group, Inc. INSURER B :Federal Insurance Company <br /> INSURER C : Pacific Indemnity Co. <br /> 12405 r-i ran <br /> Thornton, CO 80241 INSURER D_ <br /> INSURER E : <br /> INSURER F <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> TYPE OF INSURANCE POLICY NUMBER MM/DD/YEFF YYY MMJOD/YYYY LIMITS <br /> 1 =.1 <br /> LTR A GENERAL LIABILITY 35879596 10/14/2010 10/14/2011 EACH OCCURRENCE S1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurranca $1 OOO 000 <br /> CLAIMS-MADE ~ OCCUR MED EXP (Any one person) $10,000 <br /> PERSONAL & ADV INJURY $1,000,000 <br /> GENERAL AGGREGATE $2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG 32,000,000 <br /> POLICY PRO LOC $ <br /> A AUTOMOBILE LIABILITY 73564325 10/14/2010 10/14/2011 COMBINED SINGLE LIMIT <br /> IX (Ea accident) $1 000 000 <br /> AY AUTO BODILY INJURY (Per person) $ <br /> ALL OWNED AVTOS <br /> BODILY INJURY $ <br /> SCHEDULED AUTOS <br /> HIRED AUTOS PODAMAGE NON-OWNED AUTOS $ <br /> B UMBRELLA LAB X OCCUR 79672701 10/1412010 10/14/2011 EACH OCCURRENCE $1 O 000 000 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000 <br /> DEDUCTIBLE $ <br /> X RETENTION 10,000 <br /> $ <br /> C WORKERS COMPENSATION 71725194 1 0/14/201 O 10/14/2011 X WC STATU- OTH- <br /> AND EMPLOYERS' LIABILITY <br /> ANY Y I N / N 1,000,000 <br /> OFFICER/MEMBER EXCLUDED? ~ N/A EL EACH ACCIDENT $ <br /> (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $1,DDD,OUD <br /> IT y s, dascrib. untlar <br /> DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1 :000 :000 <br /> A Professional Liab 35879596 10/14/2010 10/14/2011 $5,000,000 <br /> $25,000 Deductible <br /> DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remark. Schedule, if more space is required) <br /> The certificate holder is named as an Additional Insured with respect to General Liability, as required by <br /> written contract. <br /> CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Pa meet <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> City Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Information Services Division <br /> 20 Civic Center Plaza M-12 AUTHORIZED REPRESENTATIVE <br /> Santa Ana, CA 92701 <br /> D ® 1988-2009 ACORD CORPORATION. All rights reserved. <br /> ACORD 25 (2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD <br /> #S318446/M317803 NXH <br />