HomeMy WebLinkAbout132191 MOUNTAIN PARKING EQUIPMENT - INSURANCE CERTIFICATE (3)ACORDTe CERTIFICATE OF LIABILITY INSURANCE
DATE( Y
la 27 27/2300606
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
SCA Insurance - Colo springs
4925 North union Blvd
Colorado Springs CO 80918
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
(719) 593-7016
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURERA: Employers Mutual Casualty Comp
2141S
Mountain Parking Equipment
INSURER B:
INSURER C:
2009 S Cherokee
INSURER D:
Denver CO $0223
INSURER E:
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.
INSR
ADDI
nm
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE IMMIDDIM
POLICY EXPIRATIONJ.1&
DATE (MMIDDIM
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
DAM —AGE TO RENTED
PREMISES Ea ocur e
$ 100,000
A
X COMMERCIAL GENERAL LIABILITY
OX90878
1/26/2006
1/26/2007
CLAIMS MADE ri� OCCUR
MED EXP (Any one person
$ 51000
PERSONAL 6 ADV INJURY
$ 11000,000
X $500 PD Deductible
GENERAL AGGREGATE
$ 21000,000
GENL AGGREGATE LIMIT APPLIES PER
PRODUCTS-COMP/OP AGG
$ 2,000,000
POLICY I X i PRO- LOC
A
AUTOMOBILE
LIABILITY
ANY AUTO
DE9087807
3/13/2006
1/26/2007
COMBINED SINGLE LIMIT
(Ea accident)
$ 11000,000
BODILY INJURY
(Par person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
X
X
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHERTHAN EA ACC
$
ANY AUTO
$
AUTO OHLY: AGG
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$ 11000,000
A
X OCCUR Lj CLAIMS MADE
OJ9087807
3/15/2006
1/26/2007
AGGREGATE
$ 11000,000
$
$
DEDUCTIBLE
$
X RETENTION $ 10,000
WORKERS COMPENSATION AND
TH-
WC STATUS TORY LIMITS FIR
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNERlEXECUTIVE
'
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
OFFICER/MEMBER EXCLUDED?
H yes, desaibe under
SPECIAL PROVISIONS below
E.L. DISEASE -POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
City of Fort Collins is named as an Additional Insured with respects to General Liability.
City of Fort Collins
Purchasing
Attn: John Stephens
215 N. Mason
Ft. Collins CO 80524
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
N0710E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
AUTHORIZED REPRESENTATIVE
x
ACORD 25 (2001/08)
Cc) ACOR13 CORF
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.