HomeMy WebLinkAboutRICHARD BROWN FRONTIER SAFETY - INSURANCE CERTIFICATEi
ACORD CERTIFICATE OF LIABILITY
INSURANCE
04/26 DATE/2007007/D)
PRODUCER (970) 484-2805
THIS CERTIFICATE IS ISSUED AS A MATTER -OF INFORMATION
John C. Beckett & Associates, Inc.
ONLY>AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATEDOES NOT AMEND, EXTEND OR
220 Smith Street
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Ft.'. Collins - - -- CO 80524-
INSURERS AFFORDING COVERAGE -?+^'-`
NAIC#
INSURED :' ,. ,.v".. -
Richard Brown,:DBA: Frontier Safety
INSURERA:ATLANTIC °CASUALTY INS':
INsuRER e: -
._ ....
'
INsuREac -""
15633 Janna. Dr. _
INSURER D:
INSURERS
Loveland CO 80538—
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
LTRINSRD
AbD'L
TYPEOFINSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE(MMIDD/YY)
POLICY EXPIRATION
DATE(MM/DD/YY)
LIMITS
A
GENERAL LIABILITY
-X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE ❑X OCCUR
L093002402
/ /
04/25/2007
/ /
_
04/25/2008
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED ,
PREMISES (Ea occurrence)
S lOO, OOO
MED EXP (Any one arson)
$ 5,000
PERSONAL S ADV INJURY
$ 1,000,000
GENERALAGGREGATE
$ 2,000,000
GENT AGGREGATE LIMIT APPLIES PER.
X POUCYF-1 JECOT LOG
PRODUCTS - COMPIOP AGG
$ 2,000,000
-
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULEDAUTOS
.., HIRED AUTOS ..
NON -OWNED AUTOS
_.
NO COVERAGE
.. ,..
: ..... - ...'
/ /
/ /
I /
,. .. ....
..
/ /
/
. / ./..
,.. - ... -..
COMBINED SINGLE LIMIT
(Ea amidenp
$
BODILYINJORY
(Per person)
$
BODILY INJURY t.....,
(Per amident)
$
PROPERTYpAMAGE
(Per acudent)
$ -. . _..., ..._'
..
.•
GARAGE LIABILITY
ANY AUTO
NO COVERAGE
/ /
/ /
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
8
EXCESSIUMBRELLA LIABILITY
OCCUR F-ICLAIMS MADE
DEDUCTIBLE
:RETENTION -"$ -
NO COVERAGE
-.. _ . _
/ /
/ /
__ __
/ /
/ /
.. _.
EACH OCCURRENCE
$
AGGREGATE
$
$
,.:....:.__.. .,�,_ _. _
$-., ._-
WORKERSCOMPENSATIONAND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNEWEXECUTIVE
OFFICER/MEMBER EXCLUDED?
1f yes, describe under
SPECIAL PROVISIONS below
NO COVERAGE
/ /
/ /
WC STATUS OER
E.L. EACH ACCIDENT
-
$
E. L. DISEASE - FA EMPLOYEE
EL. DISEASE -POLICY LIMIT
$
OTHER
NO COVERAGE
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
ATTN: PURCHASING & RISK MGT
CITY OF FT. COLLINS
112 N. HOWES
P O BOX 580
FORT COLLINS CO 80522-0580
?CORD 25 (2001/08)
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 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
AUTHORIZED REPRESENTATIVE
Z_ JI
® ACORD CORPORATION 1988
ttTM( INS025 (010B).m M1 ELECTRONIC LASER FORMS, INC. - (BW)327-0545 Page 1 of
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)
INS025 (oioe).os Paga2 ore