HomeMy WebLinkAboutKWAL HOWELLS INC - INSURANCE CERTIFICATEACORD,M CERTIFICATE OF LIABILITY INSURANCE
08/03/2007
08/02/2o o)
PRODUCER
Lockton Companies
444 W. 47th Street, Suite 900
Kansas City Mo 64112-1906
(816)960-9000
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE C VERA AFFORDED BY E POLICIES W.
INSURERS AFFORDING COVERAGE
INSURED PROFESSIONAL PAINT, INC.
1072127 KWAL-HOWELLS INC.
INSURER A: AM. INT. SPECIALTY LINES AIG-CHI
INSURER B. COMMERCE & INDUSTRY INS. CO.***
ATTN: PAMELA WASHBURN
3900 JOLIET STREET
D NVER CO 80239
INSURERC: *** AIG CHICAGO
INSURER 0 XL SPECIALTY INS. CO - NY
INSURER F
COVERAGES PR(1PAM 7R new �'rt i�rrsast�^r trvourtelrv�.c u�ca rvUl t.VrvA IIIU IE AGUM HAG I IdETWEEN THE ISSUING
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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.
INSR
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM/DD/YY
POLICY EXPIRATION
DATE (MMIDDIYYI
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
X COMMERCIAL GENERAL LIABILITY
1950155
08/03/2006
08/03/2007
FIRE DAMAGE (Any one fire
$ 1,000,000
MED EXP (Any oneperson)
$ 10,000
CLAIMS MADE 1XI OCCUR
X POLLUTION LEGAL LIAB
PERSONAL & ADV INJURY
$ 1,000,000
X
CLAIMS MADE FORM
GENERAL AGGREGATE
$ 2,000,000
GEN'LAGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 1000000
-
POLICY JECPROT LOC
AUTOMOBILE
LIABILITY
B
ANY AUTO
8087121 (AOS)
08/03/2006
08/03/2007
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
X
B
ALL OWNED AUTOS
CA7557775 (TX)
SCHEDULEDAUTOS
BODILY INJURY
(Per person)
$ XXXXXXX
X
HIRED AUTOS
NON -OWNED AUTOS
BODILY INJURY
(Per accident)
$ XXXXXXX
X
X
$1,000 Comp Ded
PROPSRTYen DAMAGE
$ XXXXXXX
X
$1 000 Coll Ded
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$ XXXXXXX
ANY AUTO
NOT APPLICABLE
OTHER THAN EA ACC
$ XXXXXXX
$ XXXXXXX
AUTO ONLY: AGG
EXCESS LIABILITY
EACH OCCURRENCE
$ XXXXXXX
AGGREGATE
$ XXXXXXX
OCCUR E—ICLAIMS MADE
NOT APPLICABLE
$ XXXXXXX
OUMBRELLA
XXXXXXX
DEDUCTIBLE FORM
RETENTION $
$ XXXXXXX
D
WORKERS COMPENSATION AND
RWD9435148
08/03/2006
08/03/2007
X I WC STATU-T DTH-
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1000 00o
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
THE CITY OF FORT COLLINS IS AN ADDITIONAL INSURED AS THEIR INTEREST MAY APPEAR.
1745077 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
CITY OF FORT COLLINS DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30
ATTENTION: JOHN STEPHEN, CPPB, SENIOR BUYER DAYS WRITTEN
P.O. BOX 580 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
215 NORTH MASON STREET IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
2ND FLOOR REPRESENTATIVES.
FORT COLLINS CO 80522-0580 AUTHORIZED REPRESENTATIVE
ACORD25-S(7/97) For questionsmilardingthiscertificate,contactthenumberlistedhire'Producer'sectionabo and specirythe client code 'PROPA01'. AMOR5 CORPORATION I QRR
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.