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HomeMy WebLinkAboutEXCEL SHEET METAL EXCEL BRIDGE MANUFACTURING - INSURANCE CERTIFICATEACORQ. CERTIFICATE OF LIABILITY INSURANCE 08/0 /2 0 ) PRODUCER (714) 569-2700 FAX (714) 569-3099 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Pridemark-Everest Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE A Leavitt Group Co #OF13098 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR p ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1820 E. First Street, Ste 500 Santa Ana, CA 92705 INSURERS AFFORDING COVERAGE NAIC # INSURED Excel Sheet Metal Inc. IINSURERA: Hartford Ins Co DBA: Excel Bridge Manufacturing Co. INSURER B: 12001 Shoemaker Avenue NSURER C: Santa Fe Springs, CA 90670 INSURERD: INSURER E: CnVFRACFS 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 %DDL TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE IMM1DDfYY1 POLICY EXPIRATION DATE fMM1OD1YY1 LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE ❑ OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ POLICY PROJECT LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY (Per person) (Per person) $ ALL AUTOS SCHEDULED AUTOS SCHEDULED dl;.Si�Ed7 � BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS ApF 1 PROPERTY DAMAGE (Per accident $ GARAGE LIABILITY ANY AUTO ern, RISKIviFLNA"' or rm i I ENT AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND 34WEOB2569 08/01/2006 08/01/2007 WC STATU- OTH- DRY I IMITS PR A EMPLOYERS' LUIBILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS 10 days notice of cancellation for nonpayment of premium e: Pleasant Valley Trails CERTIFICATE HOLDER CANCFI I ATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL City of Fort Collins 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, P.U. BOX 580 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 215 Madison St. OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE C Gar Wells RAV ACORD 25 (2001/08) ©ACORD CORPORATION 1988 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. ACORD 25 (2001108)