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Home My WebLink About103009 PORTER INDUSTRIES INC - INSURANCE CERTIFICATE (4)ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID R DATE(MM/DD/YYYY) PORTE-1 06 13 07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE LBN Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 4848 Thompson Pkwy ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Johnstown CO 80534 Phone:970-635-9400 Fax:970-635-9401 INSURERS AFFORDING COVERAGE NAIL# INSURED INSURER A. The Hartford INSURER B. Pinnacol Assurance Porter Industries, Inc. Attn: Cheryl Kendrick INSURER C. INSURER D: 5202 Granite Street Loveland CO 80537 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DDIYY POLICY EXPIRATION DATE MM/DDIYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 PREMISES (Ea occurence) s300,000 A X COMMERCIAL GENERAL LIABILITY 34UUNPX0464 04/30/07 04/30/08 CLAIMS MADE Fx_] OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 X Blanket Waiver X IBlanket Addrl Ins GENERAL AGGREGATE $2,000,000 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY X ECT LOC Emp Ben. 1,000,000 A AUTOMOBILE LIABILITY ANY AUTO 34UUNTX0464 04/30/07 04/30/08 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ A A HIRED AUTOS NON -OWNED AUTOS X X PROPERTY DAMAGE (Per accident) $ A Blanket Waiver GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EAACC $ ANYAUTO $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE 4038253 07/01/07 07/01/08 X TORV LIMITS ER E.L. EACH ACCIDENT $1, 000, 000 E.L. DISEASE - EA EMPLOYEE $ 1 , 000 , 000 OFFICER/MEMBER EXCLUDED? It yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1 , 000 , 000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS All Operations - All Locations The Certificate Holder is listed as Additional Insured in regard to the General Liability. CERTIFICATE HOLDER CANCELLATION FTCOLLI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN City of Ft. Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Purchasing Kristine Dept. AIMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR At 215 N. Mason REPRESENTATIVES. Fort Collins CO 80524 AU RIZE REPRE T G ACORD 25 (2001108) 10RR 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)