The URL can be used to link to this page

Home My WebLink About460607 CAMELOT CLEANERS - INSURANCE CERTIFICATE (2)ACORD,,. CERTIFICATE OF LIABILITY INSURANCE D4 /22 /2011 PRODUCER (970) 377-0638 Squires Insurance Solutions LLC 4025 Automation Way Bldg B. Suite 4 Fort Collins CO 80525- THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAICN INSURED Dean Archambo, dba Camelot Cleaners 2649 B Mulberry St,- Ste 11A Fort Collins CO 80524- IfINRERn'. Hartford Casualty Ins Co I11SUNERB: Sentinel Insurance Co IusIJRERcpinnacol Assurance "SUPER C'. INSURER E: T`( AIIH.. -FC THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT, 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 TERNIS, EiICLUSIONS AND CONDITONS OF SUCH POLICIES. AGGREGATE LIMITS SHO WPI MtiY HAVE BEEN P.E000ED BY PAID CLAIMS. INaR LTP A00'L NSRO TYPE OFINSMRANLE POLICY NUMBER POUCV EFFECTIVE GATE IM MI00/YYI POLICY E%PIgATIDN DATE MMNDIVYI UNITS A X GENERAL LIABILITY 34 SEA IS90B1 08/29/2011 08/29/2012 EACH OCCURRENCE 3 1,000,000 X COMIAERCInL GENERAL LNPWTY O.JAAGE CO RENTED PREMISE_ IEe o¢urenxl 3 TDD DDD "IMs MADE QOCCUR / / / / IAEO E%F(All ECc ptti]N $ 10,000 FERE°IIAL S ACV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2, 000, 000 GEN L AGGREGATE UI.IG APFLIE' PER PRODUCTS - COLIPIOP AGO $ 2r000, 000 .FRO- LOC POLICY r7 0?L: 5.000 H X AUTOMOBILE LIABILITY 34 TTEC JJ704 08/29/2011 08/29/2012 COMBINED 'II LIMIT IE%_::I.r.11 $ 1,000,000 ANY AUTO BODILY III:URY IFe'Y_rsod 3 X ALL OWNED AUT�OS 'CXEDVLED ALTC' / / / / EODILY IIIJURY X X HIRED AUTO' NOH0WIIEC ADO'- / / / / PROPERTY DAMAGE 3 (Ref x_J_enl) GARAGE LIABILITY AUTO ONLY. EAACCICENT 3 O HERTHAN EAACC $ ,DTI A— S AI. O ONLY: AGO A X E XCESSE.MBREILA LIABILITY 34 SEA 199881 08/29/2011 08/29/2012 EACH OCCCRREH-E $ X OCCUR ❑ CLAI'.1'MADE AGGREGATE $ mBR- 3 2,000,000 $ X DEDUCTIBLE 10, 000 / / / / 3 RETEIITICH S C WORKERS COMPENSATION AND 4142182 08/29/2011 09/01/2012 X ACSTLIMITS I ER EMPLOYERS' UASILNY ANY - EC N- UTE HACCOEN- 3 100,000 E.LOISEA'E-EAEMPLOYEE3 100,000 OFFICEPoMEMEER EXCLUDED? / / / / 4FECRL FFOVI'IOIIS m4s,v -FECALFR E1. 01'.EASE-POLICY LIMIT S 500,000 A OTHER BOPPB 34 SBA I99881 08/29/2011 08/29/2012 DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIESC W SIONS ADDED BY ENDORSEMENTISPELIAL PROVISIONS Certificate Holder iE listed se Additional Insured on hoe policy Be per pelicy forme BOG Condition, CERTIFICATE HOLDER CANCELLATION (970) 221-6775 (970) 221-6707 Purchasing Department City of Fort Collins PO Box 5BO Fort Collins CO 80527- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS W RITTEN NOTICE TD THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DD SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY HIND UPON THE AUTHORIZED REPRESENTATIVE �,f �.-'fiE.'=Jy.L2LLA�r�•� CAL INS025 (ol Esioa Psu J o1= ACORD,,. CERTIFICATE OF LIABILITY INSURANCE D4 /22 /2011 PRODUCER (970) 377-0638 Squires Insurance Solutions LLC 4025 Automation Way Bldg B. Suite 4 Fort Collins CO 80525- THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAICN INSURED Dean Archambo, dba Camelot Cleaners 2649 B Mulberry St,- Ste 11A Fort Collins CO 80524- IfINRERn'. Hartford Casualty Ins Co I11SUNERB: Sentinel Insurance Co IusIJRERcpinnacol Assurance "SUPER C'. INSURER E: T`( AIIH.. -FC THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT, 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 TERNIS, EiICLUSIONS AND CONDITONS OF SUCH POLICIES. AGGREGATE LIMITS SHO WPI MtiY HAVE BEEN P.E000ED BY PAID CLAIMS. INaR LTP A00'L NSRO TYPE OFINSMRANLE POLICY NUMBER POUCV EFFECTIVE GATE IM MI00/YYI POLICY E%PIgATIDN DATE MMNDIVYI UNITS A X GENERAL LIABILITY 34 SEA IS90B1 08/29/2011 08/29/2012 EACH OCCURRENCE 3 1,000,000 X COMIAERCInL GENERAL LNPWTY O.JAAGE CO RENTED PREMISE_ IEe o¢urenxl 3 TDD DDD "IMs MADE QOCCUR / / / / IAEO E%F(All ECc ptti]N $ 10,000 FERE°IIAL S ACV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2, 000, 000 GEN L AGGREGATE UI.IG APFLIE' PER PRODUCTS - COLIPIOP AGO $ 2r000, 000 .FRO- LOC POLICY r7 0?L: 5.000 H X AUTOMOBILE LIABILITY 34 TTEC JJ704 08/29/2011 08/29/2012 COMBINED 'II LIMIT IE%_::I.r.11 $ 1,000,000 ANY AUTO BODILY III:URY IFe'Y_rsod 3 X ALL OWNED AUT�OS 'CXEDVLED ALTC' / / / / EODILY IIIJURY X X HIRED AUTO' NOH0WIIEC ADO'- / / / / PROPERTY DAMAGE 3 (Ref x_J_enl) GARAGE LIABILITY AUTO ONLY. EAACCICENT 3 O HERTHAN EAACC $ ,DTI A— S AI. O ONLY: AGO A X E XCESSE.MBREILA LIABILITY 34 SEA 199881 08/29/2011 08/29/2012 EACH OCCCRREH-E $ X OCCUR ❑ CLAI'.1'MADE AGGREGATE $ mBR- 3 2,000,000 $ X DEDUCTIBLE 10, 000 / / / / 3 RETEIITICH S C WORKERS COMPENSATION AND 4142182 08/29/2011 09/01/2012 X ACSTLIMITS I ER EMPLOYERS' UASILNY ANY - EC N- UTE HACCOEN- 3 100,000 E.LOISEA'E-EAEMPLOYEE3 100,000 OFFICEPoMEMEER EXCLUDED? / / / / 4FECRL FFOVI'IOIIS m4s,v -FECALFR E1. 01'.EASE-POLICY LIMIT S 500,000 A OTHER BOPPB 34 SBA I99881 08/29/2011 08/29/2012 DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIESC W SIONS ADDED BY ENDORSEMENTISPELIAL PROVISIONS Certificate Holder iE listed se Additional Insured on hoe policy Be per pelicy forme BOG Condition, CERTIFICATE HOLDER CANCELLATION (970) 221-6775 (970) 221-6707 Purchasing Department City of Fort Collins PO Box 5BO Fort Collins CO 80527- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS W RITTEN NOTICE TD THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DD SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY HIND UPON THE AUTHORIZED REPRESENTATIVE �,f �.-'fiE.'=Jy.L2LLA�r�•� CAL INS025 (ol Esioa Psu J o1= IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policv(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) INS025Wiast.oc AMS Faa-3 vz IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policv(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) INS025Wiast.oc AMS Faa-3 vz