HomeMy WebLinkAboutBUSINESS INTERIORS - INSURANCE CERTIFICATEACORD CERTIFICA ABILITY INSURANCE OP ID DATE(MMIDDM') l
SIN-3 I 06/06/03
CRS Insurance Brokerage
6600 E. Hampden Ave., 2nd Flr.
Denver CO 80224
Phone:303-996-7800 Fax:303-996-7850
Business Interiors, Inc.
4141 Colorado Blvd
Denver CO 80216-4307
COVERAGES
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURER A:
INSURER B:
INSURER C:
INSURER D:
INSURERS AFFORDING COVERAGE
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.
R
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MWD
POLICY EXPIRATION
DATE MMIDD
LIMBS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE ❑X OCCUR
7690092750001
06/01/03
06/01/04
EACH OCCURRENCE
$ 1 000 000
FIRE DAMAGE (Any one fire)
f 100,000
MED EXP(Any one person)
f 5 000
PERSONAL 8 ADV INJURY
$1 , 000 , 000
GENERAL AGGREGATE
s2,000,000
GEWL AGGREGATE LIMIT APPLIES PER:
X POLICY PRO-
JECT LOC
PRODUCTS - COMP/OP AGG
s2,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
7690092750001
06/01/03
06/01/04
COMBINED SINGLE LIMIT
(Ea accident)
$1 , 000 , 000
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
S
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
S
E
A
EXCESS LIABILITY
X OCCUR 7 CLAIMSMADE
DEDUCTIBLE
X RETENTION $10 , 000
7690092750001
06/01/03
06/01/04
EACH OCCURRENCE
s3,000,000
AGGREGATE
s3 000,000
a
$
E
B
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY
4044195
06/01/03
06/01/04
TIr
X TLIMITS ER
ORY
E.L. EACH ACCIDENT
$100000
E.L. DISEASE - EA EMPLOYE
$ 100000
E.L. DISEASE -POLICY LIMIT
I $ 5 0 0 0 0 0
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER I N I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
CITYFOR
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Fort Collins
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _3Q—DAYS WRITTEN
Administrative Services
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Purchasing Division
P.O. Box 580
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Ft. Collins CO 80522-0580
REPRESE ATNES.
AUTHORIZ REPR ENT9TIVE r
ACORD 25S (7/97) CACORD CORPORATION 1983