HomeMy WebLinkAboutBARAJAS BROTHERS INC - INSURANCE CERTIFICATEACORD CERTIFICATE OF
r.
LIABILITY INSURANCE
DATE(MMIDDIVYYY)
09/04/2007
PRODUCER
Premier Insurance Group
4940 E. Evans Ave.
Denver CO 80222
PH: 303-366-7777 FAX: 303-357-5382
THIS CERTIFICATE IS ISSUED AS A
ONLY AND CONFERS NO RIGHTS
HOLDER. THIS CERTIFICATE DOES
ALTER THE COVERAGE AFFORDED
MATTER OF INFORMATION
UPON THE CERTIFICATE
NOT AMEND, EXTEND OR
BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED Barajas Brothers, Inc.
200 Racquette Drive Suite B
Fort Collins CO 80524
INSURER A: Century Surety Insurance
INSURER B:
INSURER C'.
INSURER D'.
INSURER E:
COVFRCGFR
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.
FNSR`ADD'L1
POLICY NUMBER
POLICY EFFECTIVE
DATE tMWDDIYYI
POLICY EXPIRATION
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED SEq rEeel
$ 100,000
A
% COMMERCIAL GENERAL LIABILITY
CLAIMS MADE E OCCUR
CCP 415839
04/22/2007
0412212008
MED EXP An one m.
$ Included
PERSONAL B ADV INJURY
$1,000,000
GENERALAGGREGATE
$ 2,000,000
GEN'L AGGREGATE
LIMIT APPLIES PER
PRODUCTS - COMPIOP AGO
$2,000,000
POLICY
PRO- X LOG
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ee accident)
$
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON OWNED AUTOS
_
BODILY INJURY
(Per accdent)
$
PROPERTY DAMAGE
(Per accident)
$
...
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY. AGO
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
$
DEDUCTIBLE
$
RETENTION $
ST- OT
WC TUH-
AMLT
WORKERS COMPENSATION AND
TL1RYlIR
E L. EACH ACCIDE NT
$
EMPLOYERSLIABILITY
ANY PROPRIETCRJPARTNERVEXECUTJVE
E.L. DISEASE -EA EMPLOYE
$
OFFICERIMEMBER EXCLUDED?
EL DISEASEPOLICYLIMIT
$
It yes describe under
SPECIAL PROVISIONS below
I
I
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
THIS POLICY CANCELLED EFFECTIVE 08129/2007 BY INSURED'S REQUEST.
CERTIFICATE HOLDER
City of Fort Collins
P.O. Box 580
Fort Collins, CO 80524
Fax: 970-224-6134
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 INSURER, ITS AGENTS OR
ACORD 25 (2001108)