HomeMy WebLinkAbout113109 WATERFORD CORPORATION - INSURANCE CERTIFICATE06/15/2007 12i54 FAX
2001/002
Ac RD,. CERTIFICATE OF LIABILITY INSURANCE o_
cos M0 0
W,T
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
mM International Milne of AZ
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
8310 S. Valley Highway- 3rd Fl
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Englewood CO 80112
Phone: 303 -706 - 970 D
INSURERS AFFORDING COVERAGE
NAIC 8
INSURED
INSURER OwneTB Insurance Cow Bn
32700
INSURERS. Amto•ommews maw rmae c'avyary
18988
Waterford Corporation
MSURERC: 2innacol A86uranC! Con an
404 N. Link LAae
Fort Collins CO 80522
INSURERD:
—
INSURER E:
OVERAGES
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 ISsUE0 OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMriS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR
INSRC
TYPE OF INSURANCE
POLICY NUMBER
DA MID
DATE ID
UMrTL
A
GENERAL LIABILITY
X COMMERCIALOENERALLIADIUTY
CLAIMS MADE nOCCUR
7413177807
06/23/07
06/23/08
EACH OCCURRENCE
$1000000
PREMISES EaaeturWee
$ 50000
MEG EXP(Any one Persm)
$5000
$1000000
PERSONA &AOV INJURY
GENERAL AGGREGATE
PRODUCTS-_COMPIOP AGO
_
S 2000000
OENL AGGREGATE LIMITAPPLIES PER
POLICY F7 PJECRDT LOC
$2000000
R
AUTOMOBILE
LIABIUTY
ANY AUTO
ALL OWNED AUTOS
SCHEOULEDAUTOS
HIRED AUTOS
NON -OWNED AUTOS
45131778
06/23/07
06/23/08
COMBINED SINGLE LIMIT
(Eaawden!)
$1000000
X
BODILY INJURY
(Per parson)
$
4
BODILY INJURY
(Per ecdd"
S
PROPERTYDAMAGE
(Per aeeidem)
S
GARAGE LIABILITY
ANYAUTO
AUTO ONLY - FA ACCIDENT
S
OTHER THAN EAACC
AUTO ONLY: AGG
S
S
B
EKCESWUMBRELLA LIABILITY
X OCCUR CLAIMSMADE
HDEDUCTIBLE
X RETENTION $10000
45131776
06/23/07
06/23/08
EACH OCCURRENCE
S 1000000
AGGREGATE
s 1000000. ,
S
S
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABRITY
ANY PRDPRIETOR/PARTNLRlEXECUTNE
OFFICER/MEMIDER EXCLUDED?
H yes, describe ueder
SPECIAL PROVISIONS Deis
4105522
D6/01/07
06/01/08
X TORY LIMITS ER
FL EACHACCIOENT
S 1000000
_..
El, DISEASE - EA EMPLOYEE
$1000000
E.L. DISEASE -POLICY LIMIT
S 1000000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENTI SPECIAL PROVISIONS
Verification of insurance
n..n
CjTyjpTCr SHOULD ANY OF THE ADM DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Port Collins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYSWRITTEN
Purchasing Divisin NOTICE To THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DD SO SHALL
Pax: 970 - 221- 67 07 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
215 N. Mason
Port Collins CO 80522 RCPRESENTATrM.
AU � l TAB ,
ACORD 25 (2001108) �ij/ Utf '// 0 ACORD CORPORATION 1989
06/15/2007 12:55 FAX
16002/002
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.
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