HomeMy WebLinkAbout103009 PORTER INDUSTRIES INC - INSURANCE CERTIFICATE (6)ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID R
DATE (MM/DDM YY)
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
4848 Thompson Pkwy
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Johnstown CO 80534
Phone:970-635-9400 Fax:970-635-9401
INSURERS AFFORDING COVERAGE
NAIC#
INSURED
INSURER A: The Hartford
INSURER B: Plnnacol Assurance
Porter Industries, Inc.
Attn: Cheryl Kendrick
INSURER C:
INSURERD:
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/DD/YY
POLICY RATION
DATE MM/DD/VY
LIMITS
A
GENERAL LIABILITY
X COMMERCIALGENERAL LIABILITY
CLAIMS MADE X OCCUR
X Blanket Waiver
34UUNTX0464
04/30/07
04/30/08
EACH OCCURRENCE
$ 1,000,000
PREMISES (Ea occurence)
s300,000
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 1 , 000 , 000
X
Blanket Add' 1 Ins
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY X JJPECOT LOC
PRODUCTS -COMP/OP AGG
s2,000,000
Emp Ben.
1,000,000
A
A
A
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
Blanket Waiver
34UUNTX0464
04/30/07
04/30/08
COMBINED SINGLE LIMIT
(Ea accident)
$ 1, 000, 000
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
EXCESSIUMBRELLA LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
$
$
H
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
4038253
07/01/07
07/01/08
X TORY LIMITS I I ER
1 E.L. EACI i ACCOENT
:1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1 , 000 , 000
E.L. DISEASE - POLICY LIMIT
Fs 1 , 000 000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
All Operations - All Locations
CERTIFICATE HOLDER CANCELLATION
CITYFT3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
City of Fort Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
P.O. BOX 580 REPRESENTATIVES.
Ft. Collins, CO 80524 AU RDE REPRE r
ACORD 25 (2001/08) 0 ACORD CORPORATION I9RR
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.
25 f2001/08)