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HomeMy WebLinkAboutCEDAR SUPPLY - INSURANCE CERTIFICATE (2)vvL - acoRD,. CERTIFICATE OF LIABILITY INSURANG OP ID DATE (M) DAR-6 07/07/007/04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Brown & Brown Inc - Ft Collins ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 125 S Howes, 5th Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O Box 2226 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fort Collins CO 80522-2226 Phone:970-482-7747 Fax:970-484-4165 INSURERS AFFORDING COVERAGE INSURED INSURERA: MOUNTAIN STATES MUTUAL, INSURER B: Pinnacol Assurance Cedar Supply North, Inc. Boyd Thomas (Skip) NsuRERc: 7720 South College Fort Collins CO 80525 INSURER D: 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DDIYY POLICY EXPIRATION DATE MMIDD/YY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE [K OCCUR CPP0079140 11/09/03 11/09/04 EACH OCCURRENCE $ 1, 000 000 FIRE DAMAGE (Any one fire) $100,000 MED EXP(Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRO- 17 POLICY PRO LOC JECT PRODUCTS - COMP/OP AGG $2,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS BAP0079140 11/09/03 11/09/04 COMBINED SINGLE LIMIT (Ea accident) $ 1 000 000 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 $ EAACC OTHER THAN AUTO ONLY: AGG $ $ A EXCESS LIABILITY X OCCUR CLAIMSMADE DEDUCTIBLE X RETENTION $ 10 , 000 UMB0079140 11/09/03 11/09/04 - EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY 4048795 07/01/04 07/01/05 X TORY LIMITS ER E.L. EACH ACCIDENT $ 1000000 E.L. DISEASE - EA EMPLOYEE $ 1000000 E.L. DISEASE -POLICY LIMIT I $ 1000000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS City of Fort Collins Attn: Purchasing Dept P. O. Box 580 Fort Collins CO 80522 CITYFT7 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ,10 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 ACORD 25-S AUTHORIZED ©ACORD CORPORATION 19RR