HomeMy WebLinkAboutCORRESPONDENCE - GENERAL CORRESPONDENCE - INSURANCE CERTIFICATEOCT-14-2003 16:19
si L.vrtu a
DATEi m)
14
r� h,d:CLfiaN4�
! y I.�
03
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Aon Risk Services, Inc. of Michigan
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
3000 Town Center
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Suite 3000
Southfield MI 48075
Southfield
ALTER THE COVERAGE AFFORDED Y THE POUCIE5 LOW.
COMPANIES AFFORDING COVERAGE
COMPANY Pinnacol Assurance company
PHONE- (847) 953-5726 FAX- (847) 953-5390
A
INSURED
COMPANY American Home Assurance Co.
Rocky Mountain Catastrophe Environmental
B
RmCat Environmental Services
4975 Paris Street
COMPANY
C American international specialty Lines
Denver CO 90239 USA
_
COMPANY insurance Company of the State of PA
yyyy��m'yyyy
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 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 TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
T
LTR
TYPE OF B.SURANCE
POLICY NUMBER
POLICY EFFELTII'E
DATE(-W%V0 /YV)
POLICY ESPBUT10
DATE(>ISUDN)'YI
LIMM
B
GR/fiRAL, LNDILRY
GL9332523
04/01/03
04/01/04
GENERAL AGGREGATE
52,000,000
X COMMERCIAL GENERAL 41ABILITV
General Liability
PRODUCTS •COMPA7P AGG
f2, 000,000
CLAIMS MADE rxiOOCUR
PERSONAL&AOVINXIRV
S1,000,000
OWNER'S& CONTRACTOR'S PROT
EACN OCCURRENCE
S1,000,000
FIRE OALµGE(Any we 11m)
$100,000
MEO EXP (AnY O Person)
S51000
B
AUTOMOBILE
LIABILITY
CA8261349
04/01/03
04/01/04
COMBINED SINGLE LIMIT
52, 000,000
X
ANY AUTO
Auto Liability
ALL OWNED AUTOS
BODILY INJURY
SCHEDULED AUTOS
(For pefmn)
X
HIREDAUTOS
BODILY INJURY
X
NONOwNEo AUTOS
(Pereui4an0
PROPERTY DAMAGE
OARACLE LIABILITY
AUTO ONLY - EA ACCIDENT
ANY AUTO
OTHER THAN AUTO ONLY:
EACH ACCIDENT
AGGREGAT
0
EXCESS LIABILITY
4303-3894
04/01/03
04/01/04
EACH OCCURRENCE
S5,000,000
7( UMBRELLA FORM
Umbrella Policy
AGOREGATE
55,000,000
OTHER THAN UMBRELLA FORM
A
WORKER'S COMPENSATION AND
40SL232
12/14/02
12/14/03
WCSTATURy_UAeT
OTH•
EMPLOYERS' LIABILITY
CO -workers Compensation
EL EACH ACCIDENT
500,00
THE PROPRIETOw
PARTNERS/FJ(ECUTIVE El INCL
EL DISEASE -POLICY LIMIT
5500,0
OFFICERS ARE' EXCL
EL DISEASE -FA EMPLOYEE
5500,0
C
CPL3779BS7
04/01/03
04/01/04
For oeeernnca Limit 115,000,
Contractors Pollution Liabili
X Pollutnn/rnVZoo
Aggregate Limit S15,000,0
Tp
R CRIPFORTHF
rt[MS Iy
F
RCAT RwANGELES/BPECIAL
COILINS
1
Nmawd
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CITY OF FORT COLLINS
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVORTO MAIL
ATTN: JAME5 O'NEIL II CPPO FNIGP
N DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMSD TO THE LEFT.
215 NORTH MASON STREET
P.O. BOX SBO
PUT FMLURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR DA'a Lr
FORTH COLLINS CO 80522-0580 USA
OF ANY KIND UPON THE COMPANY.ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
OenlMarA Wn- 57nnn7r=ACR
TOTAL P.03