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R T INSTALLATIONS - INSURANCE CERTIFICATE (5)
ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID C Il DATE(MMIDDIYYYY) RTINS-1 06 30 03 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Henderson Insurance Agency Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 6551 S. Revere Pkwy #135 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Englewood CO 80111 Phone: 303-706-1000 Fax:303-799-1228 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Mid -Century Insurance A INSURER B: INSURER C: R T Installations, Inc. 1649 E . 83rd Drive Denver CO 80229 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER P DATE IEFECTN Y EFID DATE EXPIRATION LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE Fx_1 OCCUR X Per Project Aggre 04594-74-39 04/03/03 04/03/04 EACH OCCURRENCE $ 1 , 000 , 000 PREMISES (Ea occurence $100,000 MED EXP (Any one person) s5,000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GENT AGGREGATE LIMIT APPLIES PER: 1-1 POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $ 2 , 000 , 0 00 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS 04594-74-39 04/03/03 04/03/04 COMBINED SINGLE LIMIT (Ea accident) $ 1 OOO OOO r r BODILY INJURY (Per person) $ X X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESSIUMBRELLA LIABILITY OCCUR F_ICLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below A0408-68-59 07/01/03 07/01/04 WC - - TORY LIMITS I I ER E.L. EACH ACCIDENT $ 100000 E.L. DISEASE - EA EMPLOYEE $ 100000 E.L. DISEASE -POLICY LIMIT I $500000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate holder is listed as additional insured with respect to General Liability. CERTIFICATE HOLDER CANCELLATION City of Fort Collins John Stephen 117 N. Mason Street PO Box 580 Fort Collins CO 80522 CITYOFF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 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 REPRESENTATIVES. ACORD 25 (2001108) © ACORD CORPORATION 1988