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HomeMy WebLinkAboutO J Watson - Insurance Certificate �® CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DD/YYYY)
�' 2/20/2025
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.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or 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 CO TACT
CRS Insurance Brokerage PHONE Jesse Hull FAX
9780 S Meridian Blvd Suite 400 303-996-7800 A'C No):303-757-7719
Englewood CO 80112 ADDRIESS: jhullgcrsdenver.com
INSURER(S)AFFORDING COVERAGE i NAIC#
INSURER A: Pinnacol Assurance 41190
INSURED OJWAT-1 INSURERB:The Travelers Indemnity Co. I 25658
O J Watson Co Inc.
DBA: OJ Watson Equip. CO INSURERC:Travelers Casualty Ins Co of 19046
5335 Franklin St INSURERD:Travelers Prop Casualty of AM _ 25674 _
Denver CO 80216 INSURER E: T
INSURER F
COVERAGES CERTIFICATE NUMBER:1792313170 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.
POLICY EFF POLICY
LTRI TYPEOFINSURANCE IND;WVDi POLICY NUMBER MWDD/YYYY MMIDDIYYY LIMITS
B X COMMERCIAL GENERAL LIABILITY Y 6303W977482 3/l/2025 3/1/2026 EACH OCCURRENCE $1,000.000
I CLAIMS-MADE I X ' OCCUR DAMAGE TO RENTED
— - --= i PREMISESjEaoccurrence $300,000
i I MED EXP(Any one person) $5,000
PERSONAL&ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
X! POLICY PRO- - ---- - - -- -- --
JECT i LOC PRODUCTS-COMP/OP AGG $2,000,000
OTHER:
C AUTOMOBILE LIABILITY Y BA3W98007A 3/1/2025 3/1/2026 COMBINED ISINGLE LIMIT $1,000,000
S- - ---)—--- --
X 1 ANY AUTO I BODILY INJURY(Per person) $
OWNED SCHEDULED i BODILY INJURY(Per accident) $
AUTOS ONLY AUTOS
X ! HIRED X NON-OWNED I PROPERTY DAMAGE Par
AUTOS ONLY AUTOS ONLY Per accident)
$
DLJEXCESS
ELLALIAB X OCCUR CUP3W981864 3/l/2025 3/1/2026 EACH OCCURRENCE $5,000,000
UAB MADEAGGREGATE $
X RETENTION$in fifinI $
A WORKERS AND EMPLO ERS'L ABILIITY YIN PENSATION 4066145 7/1/2024 7!1l2025 X STATUTE ERH
i ANYPROPRIETOR'PARTNEPJEXECUTIVE ! E.L.EACH ACCIDENT $1,000,000
OFFICERMEMBEREXCLUDED? N/A'
j(Mandatory In NH)It yes,describe under E.L.DISEASE-EA EMPLOYEE $1,000,000
, � '..
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS r VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required)
City of Fort Collins is included as additional insured for ongoing operations on the General Liability and included as additional insured on the Auto Liability with
respect to operations of the named insured for the certificate holder as required by written contract.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS.
O Box ns CO 80522
Fort Collins AUTHORIZED REPRESENTATIVE
F
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
1539: 2 ' o