HomeMy WebLinkAboutCOLEBROOK - INSURANCE CERTIFICATE (2)ACORD�, CERTIFICATE OF LIABILITY
INSURANCE
/DATE 0512004 °"" Y'
10/05/zooa
PRODUCER
Centennial Insurance Agency
C
C Box46,Ins Aurora, en 8004E
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEN, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC 9
INSURED
COLEBROOK, INC.
7332 S ALTON WAY STE A
ENGLEWOOD, CO 80112
INSURER A NATIONAL FIRE & MARINE
INSURERS: PINNACOL ASSURANCE
INSURER C:
INSURER D:
INSURER E:
CrTVFRAr:FS
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.
M8R
RDIM
TYPE OF INSUIRANCF—GENERAL
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATION
LIMITS
LIABILITY
EACH OCCURRENCE
S 1.OD0•000
DAMAGE TO RENTED
MI E a omawae
S 1000 0,0
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE � OCCUR
72LP161765
3/25/2004
3/2512D05
NED EXP ( one Down)
S 5,000
PERSONAL & ADV INJURY
S 1,000,000
GENERAL AGGREGATE
$ 2.000,000
GEWL AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMP/OPAGG
$ 2,000.000
POLICY PRO- LOC
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea acdaela)
$
BODILY INJURY
(Per Pel )
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
.(P-) ...
$
HIRED AUTOS
NON -OWNED AUTOS
...
-
PROPERTY DAMAGE
(Per acdOeM)
$
GARAGE LIABILITY
AUTO ONLY -EA ACCIDENT
$
OTHERTHAN EA ACC
$-
ANY AUTO
$
AUTO ONLY: AGG
E(CESSR/MBRELLA LIABILITY
EACH OCCURRENCE
$
13 OCCUR ® CLAIMS MADE
-
AGGREGATE
$
S
$
o DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION AND
OTH-
WC STAB ER
EMPLOYERS•LIABILITY
ANY PROPRIETORIPARTNERIEXECUT1VE
OFFICERMEMBER EXCLUDED?
4019910
5/01/2004
5/01/2005
ELEACH EACH ACCIDENT
$ 100,000
EL DISEASE - EA EMPLOYE
$ T uU'uUU
If Yes, desallom wder
SPECIAL PROVISIONS below
EL DISEASE - POLICY LINK
$ 500,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CPRTIFICATF NrN ITPR CANCFI. I ATIAN
CITY OF FORT COLLINS
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
281 N. COLLEGE AVE
DATE THEREOF, THE ISSING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
PO BOX 580
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
FORT COLLINS, CO 80522-0580
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
FAX 970-224-6134
Tw
AU114VIEN1A
ACORD 25 (2001108) C ACORD CORPORATION 1988