HomeMy WebLinkAbout132133 WASTE-NOT RECYCLING - INSURANCE CERTIFICATE (11)'u;3m3DIYY)
ACO,P CERTIFICATE OF LIABILITY INSURANCE
OD
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Van Gilder Insurance Corp.
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
700 Broadway, Suite 1000
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver, CO 80203
303 837-8500
INSURERS AFFORDING COVERAGE
BRED
INSURER A: Pinnacol Assurance
OrwPOint Employer Solutions
5665 S Yosemite St.
Suite 100
Englewood, CO 80111-3218
INSURER B.
--
INSURERr.:
_
MSURER D-.
-- -
INSURER F.
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
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TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
DATE fMMIDD)YY1 DATE IFAMPDKWVn
GENERAL LIABILITY
EACH OCCURRENCE
$
FIRE DAMAGE(Ary we Ito)
$
COMMERCIAL. GENERAL LIABILITY
_
CLAIMS MADF C.] OCCUR
AHED EXP (Any we wwn)
$
PERSONAL d ADV INJURY
$
GENERAL AGGREGATE
%
GENT AGGREGATE LIMRAPFT IFS PER.
PRODUCTS-COMPIOPAGG
$
POLICY PRO. LOC
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SNGLF LIMIT
(Ea LctlCeM)
$
BODILY INJURY -
(Perpemm)
ALL OWNEDAUTOS
SCHEDULED AU70S
$
BODILY INJURY
(Per accidenU
$
HIRED AUTOS
NON"OWNF-D AUTOS
PROPERTY DAMAGE
(Per acudern)
$
GARAGELIABLITY
AUTO ONLY - EA ACCIDENT
$
OTHERTHAN EA ACC
$
ANY AVTO
$
AUTO ONLY: AGG
EXCESS LIABILITY
EACH OCCURRENCE
$
OCCUR IX AIMS MACE
AGGREGATE
$
_
$
$
DEDUCTIBLE
$
RETENTION $
A
WORKERS COMPENSATION AND
4028674
12/01 /02
12101/03
X 1NC STAIU DTH•
EMPLOYERS, LIABILITY
E.L. EACH ACCIDENT
$500 000
F L IN%A% -FA Ew-OYEE
$500,000
E.L. DISEASE "POLICY LIMIT
$500 000
OTHER
DEBCRPTKM OF OPERAIIORSA.00AI KWSNENICLt-'"XCLUSIONB ADOEO BY ENDORSEMENI ISPECIAL PROVISIONS
This Certificate shows that Waste Not Recycling is covered under the Workers Compensation
Policy issued to One Point Employers Solutions.
SHOULD ANYOF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE TH E EXPIRATION
City of Fort Collins
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 31) DAYSWRITTEN
Attn: Jan
NOTICE TOTHE CERTIFICATE HOLDER NAMED TO THE LEFT, B UTFAILURE TO DOSO SHALL
281 N College Avenue
PA POSE NO OBLIGATION OR LIABILITY OF ANY HIND UPON THE INSURERJTS AGENTS OR
Fort Collins, CO 80524
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
L F
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