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HomeMy WebLinkAboutH2O FIRE PROTECTION - INSURANCE CERTIFICATEAC -RL�, CERTIFICATE OF LIABILITY INSURANCE 02/02/20o PRODUCER (303) 824-6600 FAX (303) 370-0118 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Moody Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 3773 Cherry Creek North Dr I ve ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 800 Denver, CO 80209-3804 INSURERS AFFORDING COVERAGE NAIC # INSURED H2O Fire Protection, Inc. INSURERA: Everest Indemnity Insurance Co 10851 2105 West Amherst Ave. INSURERB: Pinnacol Assurance Englewood, CO 80110 INSURERC: 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. INSR ADD*L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE 02/01 /2004 POLICY EXPIRATION LIMITS GENERAL LIABILITY 51 GL000287041 /BINDER 02/01 /2005 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 17X1OCCUR BLKT ADDL INSURED BLKT WAIVER OF DAMAGETORENTED $ SD 00 MED EY.P(Any one Person) $ 5,00 A X $5 , 000 PD Ded SUBROGATION PERSONAL & ADV INJURY $ 1,000,000 X E&O I nc I uded GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG $ 2,000,000 POLICY JE7 LOC AUTOMOBILE LIABILITY ANY AUTO 51 GLDD0287041 /BINDER 02/01 /2004 02/01 /2005 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ A ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY -EA ACCIDENT $ OTHER THAN EAACC $ ANY AUTO $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY 51 CC000495041 /BINDER 02/01 /2004 02/01 /2005 EACH OCCURRENCE $ 1,000,000 X OCCUR CLAIMS MADE AGGREGATE $ 1,000,000 A $ $ DEDUCTIBLE X RETENTION $ 10,00 $ WORKERS COMPENSATION AND 4039582/13OR 02/01/2004 02/01/2005 1 wc$TATLLoTH- ER B EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTNE E.L. EACH ACCIDENT Is 500,000 E.L. DISEASE -EA EMPLOYE $ SOO, OO OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below ----- -- E.L. DISEASE - POLICY LIMITIs 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS s required by a written contract only City of Fort Collins P.O. Box 580 Fort Collins, CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Renee Hofmann, CI`. ACORD 25 (2001/08) ©ACORD CORPORATION 1988