HomeMy WebLinkAbout357006 ALL AMERICAN BACKFLOW - INSURANCE CERTIFICATE (8)CLM
ACORD. CERTIFICATE OF LIABILITY INSURANCE P4DA
04-20 T2005
PRODUCER
LEID FINANCIAL GROUP INC/PHS
342560 P: (866) 467-8730 F : (877) 905-0457
P. O. BOX 33015
SAN ANTONIO TX 78265
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
INSURED
LYNNETTE KEIM DBA ALL AMERICAN BACKFLOW
820 MERGANSER DRIVE, #2105
FORT COLLINS CO 80524
INSURERA:Hartford Casualty Ins Co
INSURER B:
INSURER C:
INSURERD:
INSURERE
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
T
TYPE OF INSURANCE
POLICY NUNBER
POUCYE£PECTIVE
Yy
POLICY EXPIRATION
T Y
LIMNS
GENERAL L/A8I1NY
EACH OCCURRENCE
S1,000,000
A
COMMERCIAL GENERAL LIABILITY
34 SBA PE5367
05/26/04
05/26/05
FIRE DAMAGE (Any c,ne fire)
$300 000
CLAIMS MADE O OCCUR
MED EXP (Am one pet.
$1 Q 0 ( Q
PERSONAL & ADV INJURY
$1 000 000
X Business Liab
GENERAL AGGREGATE
S2 0 0 O 000
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGO
32 000 000
POLICY PRO X LOC
AWOMORILE
UASR/TY
COMBINED SINGLE LIMIT
$
ANY AUTO
(Ea accident)
BODILY INJURY
$
ALL OWNED AUTOS
SCHEDULED AUTOS
(Per per )
BODILY INJURY
$
HIRED AUTOS
NON -OWNED AUTOS
We, accident)
PROPERTY DAMAGE
$
(Per accidemtt
GARAGELIA8/1/TY
I AUTO ONLY EA ACCIDENT
$
OTHER THAN FA ACC
5
ANY AUTO
$
AUTO ONLY: AGG
EXCESS LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
5
5
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSA NON AND
WC STATUS OTH-
TO MIT
FMPLOYERS' UASI/TV
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY UMIT
$
OTHER
I SCR/PTION OF OPERA TIONS/LOCATrONSIVETNCIF&EXCL USIONS ADDED R Y EWORSEMEW/SPECML PROWSKNVS
Those usual to the Insured's Operations.
CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LETTER: CANCEL I ATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
The City of Fort Collins
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE (10 DAYS FOR NON-PAYMENT) TO THE CERTIFICATE
Purchasing Dept
PO BOX 580
HOLDER NAMED TO THE LEFT, BUT FAII URE TO DO SO SHALL IMPOSE NO
OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR
REPRESENTATIVES.
Fort Collins CO 80522-0580
AffTUOILIZED REPRESENTAUVE
1
ACORD 25-S (7/97) c ACORD CORPORATION 1988