HomeMy WebLinkAbout103009 PORTER INDUSTRIES INC - INSURANCE CERTIFICATE (7)sr.I"11effla li
.+1101@@h CERTIFIC. E OF INSURANCE 1DATE 2/`02/98
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc CCONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
AMEND, EXTEND OR
4821 Wheaton Drive UGC OTERRTHE (SH COVERAGE AFFORD BYCRTIFICATE DOESOTHE POLICIES BELOW
P O BOX 270370 COMPANIES AFFORDING COVERAGE
Fort Collins, CO 80527C NV
MeTcrum
& Forster
INSURED
Porter Industries, Inc.
P.O Box 27
COMPANY
BColorado Compensation Authority
Loveland, CO 80537
COMPANY
C
COMPANY
D
COVERAGES
THIS IS TO CERTIFY THAT 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 LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
Go I
LTR
TYPE OF INSURANCE POLICY NUMBER
POI ICY EFFECTIVE:PO�.3YEaPIRAT.OIN
DATE(MM/DD/YY) DATE(MM/DD/YY)
LIMITS
A
GENERAL
LIABILITY
503158114
04/30/98
04/30/99
GENERAL AGGREGATE
$2 000, 000
X
COMMERCIALGENERAL LIABILIT
CLAIMS MADE � OCCUR
PRODUCTS-COMP/OP AGO
$2 000, 000
PERSONAL&ADV INJURY
$1 000 000
EACH OCCURRENCE
$1, 000, 000
WNER'S&CONTRACTORS PROT
RPD
Ded 500
FIRE DAMAGE (Any one Ore)I$300,
000
ME D EXP(Any one person)
$15 000
A
AUTOMOBILE
LIABILITY
133644353
04/30/98
04/30/99
COMBINED SINGLE LIMIT
$1, OOO, OOO
ANYAUTO
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
X
x
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OW NED AUTOS
X
PROPERTY DAMAGE
$
GARAGE LIABILITY
AUTO ONLY -EA ACCIDENT
$
OTHER THAN AUTO ONLY
ANYAUTO
EACHACCIDENT
$
AGGREGATE
$
A
EXCESS LIABILITY
553059561
04/30/98
04/30/99
EACH OCCURRENCE
$1 000, 000
AGGREGATE
$1, 000, OOO
X UMBRELLAFORM
$
OTHER THAN UMBRELLA FORM
B
WORKERS COMPENSATION AND
1916002
01/01/98
Oi./Ol/999
X 5 ORY LIMITS
EACH ACCIDENT
$100, OOO
EMPLOYERS' LIABILITY
THE PROPRIETOR/ INCL
PARTNERS/EXECUTIVE
OFFICERS ARE x EXCL
DISEASE -POLICY LIMIT
$500, 000
DISEASE -EACH EMPLOYEE
$100, 000
A
OTHER
503158114
04/30/98
04/30/99
Limit $100,000
Employee
Dishonesty
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
RE: Carpet Maintenance Project 5300
Certificate holder is named as additional insured, but only as respects
(See Attached Schedule.)
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of Fort Collins
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Attn: James B. O'Neill, CPPO
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
PO Box 580
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
Fort Collins, CO 80522-OSBO
OF ANY KI UPO HEr COMPANY TS AGENTS OR REPRESENTATIVES
AUTHORIZEUREP TAT
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ACORD25•S(3/93)1 of 2 S119181 M105906
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P 0ACORDCORPORATION 1993
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