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<br />CERTIFICATE OF LIABILITY INSURANCE OAT 2'074DVYYV)
<br />/2014
<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 CONTRACTM.+TWEEN �rNE I$,�ulryj; I�$URER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. L��``'' JJFFn'' ! fi iti N t{
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A sJeniJfit(ori this ertifl at a not confer rights to the
<br />s).
<br />certificate holder in lieu of such endorsement "'�'+
<br />PRODUCER NAM TA T r L?i' i'1.
<br />USI Colorado LLC PHONE FA) No:
<br />1515 Wynkoop, Suite 200 E -MAIL
<br />Denver CO 80202 1{ _(� 0/1 JX J 00 ADDRESS:
<br />INSURERS AFFORDING COVERAGE NAIC p
<br />IUC,IRFR A-VI Cnnniol4,i Inoi,.n r1n
<br />INSURED INTCON6
<br />Interwest Consulting Group
<br />Naffa, Inc.; Vernon Brown & Associates, Inc.
<br />P.O. Box 18330
<br />Boulder CO 80308
<br />COVERAGES CERTIFICATE NUMBER: 1526639231 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 />ILTR
<br />TYPE OF INSURANCE
<br />INSR
<br />MD
<br />POLICYNUMBER
<br />POLICY EFF
<br />MMIDDIYYYV
<br />POLICY EXP
<br />MMIDDM'YY
<br />LIMITS
<br />D
<br />GENERAL LIABILITY
<br />Y
<br />Y
<br />3807460M671
<br />11/14/2013
<br />1/14/2014
<br />EACH OCCURRENCE
<br />$2,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />rv7
<br />PREMISES ' REIN I ante
<br />Ea
<br />$1,000,000
<br />CLAIMS -MADE I OCCUR
<br />MED EXP(Any one person )
<br />$10,000
<br />PERSONAL & ADV INJURY
<br />$2,000,000
<br />GENERALAGGREGATE
<br />$4,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER
<br />PRODUCTS - COMP /OP AGO
<br />$4,000,000
<br />$
<br />] JECT 71 POLICY X PRO- LOC
<br />E
<br />AUTOMOBILE
<br />LIABILITY
<br />Y
<br />Y
<br />BA746610429
<br />11/14/2013
<br />1/14/2014
<br />UP LIMIT
<br />Ea accident
<br />1000000
<br />BODI LY INJURY (Per person)
<br />$
<br />X
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />X
<br />NON -OWNED
<br />HIRED AUTOS X AUTOS
<br />B
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />Y
<br />Y
<br />CUP4175T615
<br />11/14/2013
<br />1/14/2014
<br />EACH OCCURRENCE
<br />$1,000,000
<br />AGGREGATE
<br />$1,000,000
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED X I RETENTION$O
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />y
<br />VMPJU111339T934
<br />11/14/2013
<br />1/14/2014
<br />X WCSTATU- I GTH-
<br />ER
<br />ANY PROPRIETORIPARTNER /EXECUTIVE❑
<br />E. L. EACH ACCIDENT
<br />$1,000,000
<br />OFFIOER/MEMBER EXCLUDED?
<br />NIA
<br />E.L. DISEASE - EA EMPLOYEF
<br />$1,000,000
<br />(Mantlatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$1,000,000
<br />A
<br />Professional Liability
<br />DPR9710356
<br />11114/2013
<br />1/1412014
<br />Per Claim $1,000,000
<br />Claims Made
<br />Annual Aggregate $3,000,000
<br />Relro Date: 6/1/2002
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
<br />As required by written contract or written agreement, the following provisions apply subject to the policy terms, conditions, limitations and
<br />exclusions: The Certificate Holder is included as Additional Insured for your work, acts or omissions which includes completed operations
<br />under General Liability; Designated Insured under Automobile Liability; and Additional Insured under Umbrella / Excess Liability but only with
<br />respect to liability arising out of the Named Insured's work performed on behalf of the certificate holder and owner. This insurance will apply
<br />on a primary and non - contributory basis. A Blanket Waiver of Subrogation applies for General Liability, Automobile Liability, Umbrella /Excess
<br />Liability and Workers Compensation. The Umbrella / Excess Liability policy provides excess coverage over the General Liability, Automobile
<br />See Attached...
<br />1SHOULD ANY OF T HE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City Of Santa Anaura Stitt heedy. ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center P
<br />Santa Ana CA 92701 Assistant. Ct Attorney, AUTHORIZED REPRESENTATIVE
<br />t71gRR.2010 ACORn CORPORATION_ All rinhfc racerved
<br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
<br />
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