HomeMy WebLinkAboutEXODUS MOVING AND STORAGE INC - INSURANCE CERTIFICATE1970221G707(x>fax.tc Brown6rownlns Pa�cs=2 09/08/2023 1Q�33�a5 AM
�� �� CERTIFICATE OF LIABILITY INSURANCE DATE(MMlD�IWW)
�y= 09/08/2023
THIS CERTIFICATE IS ISSUED ASA MATTER �F INFORMAl10N ONLYAND CONFERS ND RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NdTAFFIRMAIIVELY OR NEC3ATIVELYAMEND, EXTEND OR ALTER THE COVERAOE AFFORDED BY THE POLICIES
BELOW. THI3 CERl1FICATE OF INSURANCE D�ES NOT CONSIITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTAl1VE OR PRODUCER, AND THE CERIIFICATE HOLDER.
. e cer ca e o er s an , e po cy es mus ave prov s ons or e en orse .
If SUBRO�ATION IS WAIVED, subJect to the terms and condltlons of the pollcy, certaln pollcles may requlre an endorsement. A statement on
thls certlflcate does not confer rlghts to the certlflcate holder In Ileu of such endorsement(s).
PRODUCER NAME; K�ren Siwek
Brown & Brown of Colorado, Ino. (670) 482-7747 Arc No �(070) 484-4186
4632 Boardwalk Dr., Suite 200 ,;,npFpp. 266,Certificates�bbrown,com
INSURER S AFFOR�ING COVERAGE NAIC N
FortCollin9 CO 80525 iNsuRER,y� SecurityNationallnsuranceCompany
�NsuReo iNsuReRe � Mllfortl Casualry Insurance Company
Exodua Moving and Storage Inc IN9URERC ;��nite State Ineurance Company
8608 Ea9t US HiBhway 34 iNsuR�Ro ; Pinnacol Assurance 41190
INSURER E '
Johnstown CO 80534 INeURERF;
C�VERAGE3 CERTIFICATE NUMBER: c�zsse�osn REVISIDN NUMBER:
TFIIS IS TO CERTIFY TNAT TNE POLICIES OF INSUR.4NCE LISTED BELOW NAVE 9EEN ISSUED TO THE INSURED NAME�A90VE FOR THE POLICY PERIOD
INDICATED. NOTIMTHSTRNDINO ANY RE�UIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOGUMENT WITH RESPECT TO WHIGH THIS
CERTIFICATE MAY BE IS3UED dR MAY PERTAIN, TNE INSURANCEAFFORDED BY TNE POLICIE& DEBCRIBED HEREIN IS SUBJECT TOALL TNE TERMS,
EXCLUSIONSAND CONDITIONS OF SUCH POLICIES, LIMITS SHQWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
L7R TYPE oF INSURANCE POLICY NUMBER MMlDDIWY MMIDDlWY LIMITS
� CQMMERCIAL OENEFL4L LIA8ILITY EACH OCCURRENCE � � �000,000
CLAIM3MADE � OCCUR PREMISES Eev�currence $ ���,���
MEd EXP An�� bn5 �9r90t1 5,000
A SPP178034704 09/01l2023 OB101l2024 FEp�c�NA�uA�viN�uRv $ 1,000,000
GEN'LAGGRECiATELIMITAPPLIESFER GENERALAia�iREVHTE $ �i000,000
PRO- 2, 000, 000
X PCiLICY JECT � LC:�� PROLI,I;,'Tg-c_qN1FlOPAGG �
OTHEG $
AUTOMOBILE LIABILIN E s�cldrnt� $ 1�000,000
x ANl' AUTO BGGILY IfJJLiFY �Per pBr90n) $
g owNED SCNEDULED WPP1632938 04 09/01/2023 09/01/2024 B�:�C?ILY INJI IRV (Par accident) $
AUTOS QNLY AUTOS
HIRED NON•OWNED g
AUTpS ONLY AUT�S 4NLY er acci ent
g
�( UMBRELLALIA6 jM� e���UR EACHOCCURRENCE g 5,000,000
C EXCESS LIA6 CLAIMSMADE SMB1A09713 00 Og����2�22 ����C�/2��3 AGGREGATE $ 5,���,���
aeo `1C �Ere��Tiord g 10,000 $
WORKERB COMPENBATION 'iC �ET UTE ERH
AND EMPLOYERS' LIABILITY y! � 1, OOO,OOO
p ANYFROFRIETORiPARTNERIEXECUTIVE � N!A 4219185 09/01/2023 09/01/2024 E.L EACHACCIDENT
OFFICERIMEMBER EXGLUDED7
iMentletory In NM} E.L DISEASE - EA EMPLOYEE $ �, 000,��0
Ifyve, describv under 1,000,000
DESCRIPTInPJ OF GPE�ATIONS below E.L DISEASE - GOLICY LI�AIT $
Transportatlon
Caryo Llmlt $600,000
A 012418706-4 08/01l2023 08/01I2024 Warehouse Limit9 See Note9
DE9CRIPTION OF OPERATION81 LOCAT10N9! VEHICLEB (A�ORD 101, Addltlonal R�muka 8ch�dul�, may b� attach�d if mon opaw lo nqulnd)
SHOULO ANY OF THE ABOVE DESCRIBED Pt�LICIES BE CANCELLED BEFQRE
THL' �XPIRA710N DA'TE Ti�R�O�, NOTIG� WILL DE DELIV�RCD IN
City of Fort Collin9 Purohaaing Division ACCORDANCE WITH THE POLICY PRQVISIONS.
PO Box 560
AUTNORI2ED REPRE8ENTp'T1VE
Fort Collins co eoszz-oseo ` � . � � '
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� 1988-2015 ACORD CORPORAT10hl. All rlghts reserved.
ACORD 25 (2016103� The ACORD name and logo ara rsglaterad marka of AC4RD
1970221G707(x>fax.tc Brown6rownlns Pa�cs=2 09/08/2023 10�33�a5 AM
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AGENCY CUSTOMER ID: 00312258
LOC #:
ADDITIONAL REMARKS SCHEDULE
Page of
AOENGY NRMEDIN9URED
Brown & Brown of Coiorado, Inc. Exodus Moving and Storage Inc
POLICY NUMBEfi
CARRIER NAIC GODE
EFFECTIVE DATE:
ADDI110NAL FtEMARKS
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