HomeMy WebLinkAboutCEDAR SUPPLY NORTH - INSURANCE CERTIFICATE (2)acORD,. CERTIFICATE OF LIABILITY INSURANCE OP ID
DAR-6
DATE(MMIDDIYY)
11/04/03
PRODUCER
Brown 6 Brown Inc - Ft Collins
125 S Howes, 5th Floor
P O Box 2226
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.
Fort Collins CO 80522-2226
Phone:970-482-7747 Fax:970-484-4165
INSURERS AFFORDING COVERAGE
INSURED
INSURER A: MOUNTAIN STATES MUTUAL
Cedar Supply North, Inc.
Boyd Thomas (Skip)
INSURER B: Plnnacol Assurance
INSURER C:
7720 South College
Fort Collins CO 80525
NsuRERD:
INSURER E:
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
POLICYEFFECTIVE
DATE MMIDDNY
POLICYEXPIRATION
DATE MMIDDIYY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENEFAIL LIABILITY
CLAIMS MADE ❑X 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
s2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
POLICY PRO LOC
JECT
PRODUCTS -COMP/OP AGG
$2,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULEDAUTOS
HIREDAUTOS
NON -OWNED AUTOS
BAP0079140
11/09/03
11/09/04
COMBINED SINGLE LIMIT
(Ea accident)
1 000
$ r r 000
BODILY person)
(Per person)
$
X
X
BODILY INJURY
(Per accident)
$
X
�I.
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
fir
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
EA ACC
OTHERTHAN
AUTO ONLY: AGG
$
$
A
ESS LIABILITY
tX�OCCUR CLAIMSMADE
DEDUCTIBLE
X RETENTION $ 10 000
UNB0079140
11/09/03
11/09/04
EACH OCCURRENCE
$ 1 , 000 , 000
AGGREGATE
$1,000,000
$
B
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY
OTHER
4048795
07/01/03
07/01/04
X TORY LIMITS ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
_$_1000QQ0
j000000
E.L. DISEASE -POLICY LIMIT $ 1000000
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
! COTICI^AT0.I . n'e
—v--LIB I C1 I AUUI I IVNAL INSUKGU; INSURER LETTER:
CITYFT7
City of Fort Collins
Attn: Purchasing Dept
P. O. Box 580
Fort Collins CO 80522
GANGELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO
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
REPRESENTATIVES.
25-S (7/97)