HomeMy WebLinkAbout113109 WATERFORD CORPORATION - INSURANCE CERTIFICATE (13)ACORD- CERTIFICATE OF LIABILITY INSURANCE 0DATE
6/16/04D1Y
YYYI
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
211 First Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Eaton, CO 80615
970 454-3381 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURERA: CNA Insurance Company
Waterford Corporation
Po Box1513
Ft. Collins, CO 80522
INSURER B:
INSURER C:
INSURER D:
INSURER E:
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.
LTRINSK
NSR
TYPE OF INSURANCE
POLICY NUMBER
PDATEYMM/DDIYYE
POLICY
MMIDDIYYI
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 51 OCCUR
B1036418119
06/23/04
06/23/05
EACH OCCURRENCE
$1 UUU 000
DAMAGE TO RENTED ncel
PREMISE Ma CCU
$1 OO OOO
MED EXP (Any one person)
$5 000
PERSONAL &ADV INJURY
$1 UUU 000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PROJECT LOC
PRODUCTS-COMP/OP AGG
$1 000000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULEDAUTOS
HIREDAUTOS
NON-OWNEDAUTOS
B1036418122
06/23/04
06/23/05
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,UUU
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTOONLY: AGG
$
$
A
EXCESS/UMBRELLA LIABILITY
-X1 OCCUR CLAIMS MADE
RDEDUCTIBLE
X RETENTION $ 1U 000
B2054184862
06/23/04
06/23/05
EACH OCCURRENCE
$1000000
AGGREGATE
$1 UUU UUU
$
$
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNEWEXLCUTI✓E
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
I
WC STATU- OTH-
RLIMITS
E.L. EACH ACCIDENT
$
E.L. DISEASE. - EA EMPLOYE
$
E.L. DISEASE - POLICY LIMIT
I $
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
City of Fort Collins
Purchasing Division
215 N. Mason
Fort Collins, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1 n DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO D SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
AUTHORIZED REPRESENTATIVE
ACORD 25 (2001108) 1 of 2 #S285070/M285059 TXC 0 ACORD CORPORATION 1988
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-S (2001/08) 2 Of 2 #S285070/M285059